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TissueDB/Simulators/Open Appendectomy Simulator (Matthews)

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General Information

The Matthews Open Appendectomy Simulator (AMPATH Surgical App) is an ultra-low-cost open-appendectomy trainer for resource-limited surgical training programmes. It combines an eight-layer abdominal-wall analogue (skin, superficial fat, Scarpa's fascia, deep fat, external oblique aponeurosis, external oblique muscle, internal oblique muscle, peritoneum) over a glove-based appendix–cecum complex inside a small plastic container, supporting the four sections of an open appendectomy: safe entry into the abdomen, identifying the appendix, appendectomy, and abdominal closure. A complete trainer is built from everyday consumables for a few US dollars.[1]

Field Details
General Information Ultra-low-cost open-appendectomy trainer for resource-limited surgical training. An eight-layer abdominal-wall analogue (skin, fat, fascia, oblique muscle planes, peritoneum) over a glove-based appendix–cecum complex in a small plastic container lets a trainee practise all four sections of an open appendectomy on everyday materials.
Features and Basic Operation An eight-layer abdominal-wall analogue over a glove-based appendix–cecum complex in a small plastic container. The trainee opens the abdominal wall, identifies the appendix, ligates the appendiceal artery within the mesoappendix, removes the appendix, and closes the wall — covering all four sections of an open appendectomy.[1]
Current Development Status Validated. Built and tested through a two-round iterative-development study with surgeons and trainees.[1]
Estimated Build Time and Cost Approximately 60 minutes (source target, not formally measured)[1], ~US$4[1]
Specialized Tools and Equipment None — built from everyday consumables and practised with standard open-surgery instruments.[1]
Version Not stated in source
Development Team Contact Information AMPATH surgical team — Indiana University (Indianapolis, IN); Moi University and Moi Teaching and Referral Hospital (Eldoret, Kenya); University of South Carolina and Prisma Health (Columbia, SC); and CaseNetwork (Philadelphia, PA). First author: J. Matthews.[1]

Tissues

Tissue Qty Material Cost Notes
Skin 1 sheet Vinyl Part of ~US$1 consumable set Outermost surface of the abdominal-wall stack — the skin the trainee opens first.[1]
Subcutaneous Tissue (superficial fat) 1 sheet Polyester Batting (yellow-dyed) Part of ~US$1 consumable set Yellow-dyed batting for the superficial fat plane beneath the skin.[1]
Scarpa's fascia 1 sheet Plastic Wrap Part of ~US$1 consumable set Plastic film between the superficial and deep fat planes; distinct from the peritoneal sheet.[1]
Subcutaneous Tissue (deep fat) 1 sheet Polyester Batting (yellow-dyed) Part of ~US$1 consumable set Yellow-dyed batting for the deep fat plane beneath Scarpa's fascia.[1]
External oblique aponeurosis 1 sheet Cotton Fabric Part of ~US$1 consumable set Cotton fabric standing in for the tough aponeurotic sheet over the external oblique.[1]
Muscle (external oblique) 1 sheet Cotton Batting Part of ~US$1 consumable set Cotton batting for the external oblique muscle; its fibre striations run opposite the internal oblique to convey crossing fibre directions.[1]
Muscle (internal oblique) 1 sheet Cotton Batting Part of ~US$1 consumable set Cotton batting for the internal oblique muscle; striations run perpendicular to the external oblique.[1]
Peritoneum 1 sheet Plastic Wrap Part of ~US$1 consumable set Plastic film as the innermost sheet of the abdominal-wall analogue.[1]
Cecum 1 Glove + cotton ball fill Part of ~US$1 consumable set Base of a surgical glove with a cotton-ball fill, forming the cecum.[1]
Appendix 1 Glove (third finger) Part of ~US$1 consumable set The third (middle) finger of the surgical glove represents the appendix.[1]
Mesoappendix 1 Surgical Mask (scrub-cap material) + Red yarn Part of ~US$1 consumable set Scrub-cap material around red yarn, representing the mesoappendix that carries the appendiceal artery.[1]
Appendiceal Artery 1 Red yarn Part of ~US$1 consumable set Red yarn inside the mesoappendix; the ligation target during the appendectomy.[1]
Terminal Ileum 1 Glove (thumb) Part of ~US$1 consumable set Glove thumb representing the terminal ileum at the ileocecal junction.[1]


Structural Parts

Part Name Qty Material Cost Notes
Plastic container 1 Plastic (~20 × 10 × 10 cm) Part of ~US$3 reusable set Holds the abdominal-wall stack and the appendix–cecum complex; reused across builds.[1]
Binder clips Multiple Metal Part of ~US$3 reusable set Hold the abdominal-wall stack against the container rim; reused across builds.[1]
Suture As needed Suture thread Part of ~US$1 consumable set Used during construction to join the mesoappendix to the appendix.[1]
Surgical-mask tie 1 length Surgical Mask (tie portion) Part of ~US$1 consumable set Tie portion of a surgical mask, representing the tenia coli along the cecum.[1]
Marker 1 Marker pen Part of ~US$1 consumable set Used during construction for the muscle-fibre striations on the cotton batting.[1]


Build Instructions

Phase 1: Construct the eight-layer abdominal-wall analogue

  1. Cut the vinyl skin layer to the container's interior cross-section.[1]
  2. Cut a yellow-dyed polyester batting sheet for the superficial subcutaneous-fat layer.[1]
  3. Cut a plastic-wrap sheet for Scarpa's fascia.[1]
  4. Cut a second yellow-dyed polyester batting sheet for the deep subcutaneous-fat layer.[1]
  5. Cut a cotton fabric sheet for the external oblique aponeurosis.[1]
  6. Cut two cotton batting layers for the external oblique and internal oblique muscles.[1]
  7. Use a marker to draw fibre striations on each cotton-batting layer; orient the external oblique striations perpendicular to the internal oblique striations to convey opposing fibre directions.[1]
  8. Cut a second plastic-wrap sheet for the peritoneum.[1]

Phase 2: Construct the appendix-cecum complex

  1. Inflate the base of a surgical glove with a cotton ball to form the cecum.[1]
  2. Excise the second, fourth, and fifth fingers of the glove (the auxiliary fingers); leave the thumb in place to represent the terminal ileum at the ileocecal junction.[1]
  3. Fold a piece of scrub cap around a length of red yarn to form the mesoappendix containing the appendiceal artery.[1]
  4. Suture the mesoappendix-and-yarn assembly to the third (middle) finger of the glove (the appendix).[1]
  5. Affix a surgical-mask tie from the base of the third finger to the wrist of the glove to represent the tenia coli.[1]

Phase 3: Final assembly

  1. Stack the eight abdominal-wall layers inside the plastic container from deepest to most superficial: peritoneum (plastic wrap) then internal oblique (cotton batting) then external oblique (cotton batting) then external oblique aponeurosis (cotton fabric) then deep fat (polyester batting) then Scarpa's fascia (plastic wrap) then superficial fat (polyester batting) then skin (vinyl).[1]
  2. Secure the layered abdominal wall to the plastic container with binder clips.[1]
  3. Position the appendix-cecum complex inside the container beneath the abdominal-wall analogue, oriented so the appendix can be approached through the open-appendectomy incision.[1]



References

[1]

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 1.39 1.40 1.41 1.42 Matthews J, Bhatia MB, Thomas C, Okoth P, Martinez CR, Levy JS, Stefanidis D, Hunter-Squires JL, Saruni SI (2022). "AMPATH surgical app: Low-cost simulator for the open appendectomy." Surgery 172(6):1656–1664. DOI: 10.1016/j.surg.2022.07.023. PMID: 36123174. © 2022 Elsevier Inc.




Simulator data
Alternative names AMPATH Surgical App (open appendectomy module); AMPATH Open Appendectomy Simulator



Page data
Keywords open appendectomy, appendectomy simulator, AMPATH Surgical App, Matthews, Indiana University, Moi University, Kenya, low-cost simulator, abdominal wall simulator, glove-based appendix model, resource-limited surgical training, ultra-low-cost simulator
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Authors Arturopelayo
License CC-BY-SA-4.0
Language English (en)
Related 0 subpages, 12 pages link here
Views 8 page views (analytics)
Created May 13, 2026 by Arturo Pelayo
Last edit May 25, 2026 by StandardWikitext bot
Cite as Arturopelayo (2026). "TissueDB/Simulators/Open Appendectomy Simulator (Matthews)". Appropedia. Retrieved June 4, 2026.
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