TissueDB/Simulators/Neonatal Enterocutaneous Anastomosis Simulator
General Information
Medical officers (non-specialist physicians) and general surgeons use this frugal simulator to gain confidence and competence in the gentle handling of delicate infant tissues. The skill applies to neonatal colostomy procedures performed in low to middle income countries (LMICs). The thin cigarette paper, especially when moistened, simulates the delicate tissue of neonatal bowel.
| Field | Details |
|---|---|
| General Information | Source: Colostomy in Newborns by Medical Makers. Designed for medical officers and general surgeons in LMICs who perform neonatal colostomy procedures without access to pediatric surgeons. |
| Features and Basic Operation | Teaches gentle and delicate tissue handling, avoiding crushing tissue, avoiding tight sutures, and avoiding undue tension and pull during neonatal enterocutaneous anastomosis. The cigarette model simulates the fragile, delicate tissues of a neonate. Each simulator (two cigarettes) accommodates about four sutures. |
| Current Development Status | First pass engineering |
| Estimated Build Time and Cost | No build time required. Simulator cost: USD 0.05–0.10 per pair of cigarettes (excluding reusable surgical instruments). |
| Specialized Tools and Equipment | Not stated in source |
| Version | Not stated in source |
| Development Team Contact Information | Medical Makers |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Bowel | 2 | Cigarette | USD 0.05–0.10 | Thin cigarette paper, especially when moistened, simulates delicate neonatal bowel tissue. Each simulator consists of a pair of cigarettes. |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Needle driver | 1 | Standard | — | Reusable. Standard needle holder; typically provided by training institution. |
| Dissecting forceps | 1 | Smooth (non-toothed) | — | Reusable. Smooth, non-toothed tips required for gentle tissue handling practice. Typically provided by training institution. |
| Mayo scissors | 1 | Standard | — | Reusable. Cut sutures and stabilize the proximal end of the cigarette closest to the learner. Typically provided by training institution. |
| Cup | 1 | Any reusable cup | — | Reusable. Holds clean water to moisten cigarette paper for intermediate and advanced training levels. |
Consumables
| Consumable | Quantity | Material | Approximate Cost | Notes |
|---|---|---|---|---|
| Silk suture | Varies | 4-0 or 5-0 with round bodied (tapered) needle | — | Inexpensive silk sutures suggested for training to maximize affordability. Use 4-0 or 5-0 Vicryl or PDS sutures with round bodied needle for actual procedures on patients. |
| Water | 1 cup | Clean water | — | Used to moisten cigarette filter and lighting ends for intermediate, advanced, and expert training levels. |
Build Instructions
Phase 1: Material preparation
Step 1: Obtain a pair of cigarettes. A single pair of cigarettes costs approximately USD 0.05–0.10 (5–10¢) and is the only consumable required per simulation session.
Step 2: Gather surgical instruments. Collect a standard needle driver, smooth (non-toothed) dissecting forceps, and Mayo scissors.
Step 3: Thread the suture. Thread 4-0 or 5-0 silk suture through the round bodied (tapered) needle.
Step 4: Prepare clean water. Fill a reusable cup with clean water and place it within reach of the work surface.
Phase 2: Simulator assembly
Step 1: Position the simulator for suturing. No assembly is required. Place the pair of cigarettes on the work surface and position the Mayo scissors on the proximal end of the cigarette closest to the learner to stabilize it during suturing practice.
References
- ↑ Wong J, Udeigwe-Okeke C, Ameh E. Colostomy in Newborns training module. Appropedia, 2021. Available at: https://www.appropedia.org/Colostomy_in_Newborns
Digital Resources
Training videos (see Gentle Tissue Handling Skills for the full skills training module):
- Overview — Gentle Tissue Handling Skills
- Step 1 — Basic Skills Training
- Step 2 — Intermediate Skills Training
- Step 3 — Advanced Skills Training
- Step 4 — Expert Skills Training (optional)
| Alternative names | Neonatal Colostomy Simulator Descending Colostomy Simulator Cigarette Suturing Simulator Neonatal Bowel Anastomosis Trainer Pediatric Bowel Anastomosis Simulator Cigarette Model |
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| Authors | |
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| License | CC-BY-SA-4.0 |
| Cite as | "TissueDB/Simulators/Neonatal Enterocutaneous Anastomosis Simulator". Appropedia. 2026. Retrieved June 3, 2026. |