TissueDB/Simulators/Neonatal Enterocutaneous Anastomosis Simulator
The Neonatal Enterocutaneous Anastomosis Simulator is a very low-cost trainer built from locally available materials — a pair of cigarettes — that medical officers and general surgeons use to practise the gentle handling of delicate neonatal tissues for enterocutaneous anastomosis during a newborn colostomy.[1] The thin cigarette paper, especially when moistened, stands in for the fragile bowel tissue of a neonate, and one pair accommodates about four sutures. The skill applies in low- and middle-income countries (LMICs) where colostomies in newborns are often performed without a paediatric surgeon.
| Field | Details |
|---|---|
| Features and Basic Operation | The cigarette model reproduces the fragile, delicate feel of neonatal bowel tissue. One simulator is a pair of cigarettes and accommodates about four sutures; the filter or lighting ends may be sutured dry or moistened. Four is a fraction of the real step, which the source says takes an average of 8–12 sutures. The module answers that shortcoming with a mastery rule rather than a bigger model: the learner must complete a minimum of 12 consecutive sutures across 3 pairs of cigarettes. |
| Current Development Status | Skills prioritised by a survey of 16 paediatric surgeons worldwide through the Global Initiative for Children's Surgery (GICS). User-tested on 29 September 2021 by five medical officers at the National Hospital of Abuja, Nigeria: all five reached the advanced level, three reached the optional expert level unaided, and two of those three completed the procedure on live animal models. The source describes no expert review of the simulator itself. |
| Estimated Build Time and Cost | US$0.05–0.10 |
| Specialized Tools and Equipment | Standard needle driver, smooth (non-toothed) dissecting forceps, and Mayo scissors (to cut sutures and stabilise the proximal end of the cigarette closest to the learner). These reusable surgical instruments are typically provided by the training institution. |
| Version | Version 1 |
| Development Team Contact Information | Medical Makers (Medical Makers) |
Source — every material, build step, and cost on this page is drawn from the Medical Makers "Colostomy in Newborns" training module (Colostomy in Newborns) unless a cell notes otherwise.
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Bowel | 2 | Cigarette | US$0.05–0.10 | Thin cigarette paper, especially when moistened, simulates delicate neonatal bowel tissue. Each simulator consists of a pair of cigarettes. |
Consumables
| Consumable | Quantity | Material | Approximate Cost | Notes |
|---|---|---|---|---|
| Silk suture | Varies | 4-0 or 5-0 silk suture 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 ends at two of the four levels: intermediate (wet filter ends) and the optional expert level (wet lighting ends). Basic and advanced are both sutured dry. |
Build Instructions
Phase 1: Material preparation
Step 1: Obtain a pair of cigarettes. A pair of cigarettes 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: Setup and positioning
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; module page (revision 1236236, retrieved 12 July 2026). The moistening and pair-of-cigarettes statements are on the module's Phase 2 page: Neonatal Enterocutaneous Anastomosis Simulator.
Sources consulted for this page but not cited at a specific claim:
- Wong J, Udeigwe-Okeke C, Ameh E. Colostomy in Newborns training module. Appropedia, 2021. Available at: https://www.appropedia.org/Colostomy_in_Newborns. The moistening and pair-of-cigarettes statements are on the module's Phase 2 page: Neonatal Enterocutaneous Anastomosis Simulator.
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 | Pediatric Bowel Anastomosis Simulator Cigarette Model |
|---|
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Neonatal Enterocutaneous Anastomosis Simulator". Appropedia. Retrieved August 24, 2026. |