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. 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. |
| Current Development Status | Expert-reviewed |
| 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) |
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 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 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. 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 | 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 July 9, 2026. |