TissueDB/Simulators/Vascular Anastomosis Simulator (Cubas)
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General Information
The Vascular Anastomosis Simulator (Cubas) is a home-made, low-cost, portable bench trainer for practising end-to-side, side-to-side and end-to-end vascular anastomoses on plastic-straw vessel surrogates.[2]
| Field | Details |
|---|---|
| General Information | A home-made, low-cost, portable bench trainer that lets cardiothoracic-surgery residents practise end-to-side, side-to-side and end-to-end vascular anastomosis at home. A 2024 multicentre study by the same author extends the design across several Peruvian centres;[3] this page covers the 2022 single-author paper. As described in Cubas 2022 (Cirugía Cardiovascular 29:82–88).[2] |
| Features and Basic Operation | A home-made, portable bench frame for practising microsurgical vascular anastomosis. Four "fitted parts" — each a small crocodile-type hook bound with galvanized wire to a chrome curtain bracket — bolt to the floor of a lidded plastic container, arranged in parallel for side-to-side anastomosis or perpendicular for end-to-end and end-to-side. Thin plastic straws (15 cm × 2–3 mm lumen) clip into the hooks as vessel surrogates, and the trainee sutures them with a Castroviejo needle holder and fine polypropylene suture. The lid lets the rig be carried and used at home.[2] |
| Current Development Status | Home-made; peer-reviewed, preliminarily evaluated. Cubas 2022.[2] |
| Estimated Build Time and Cost | US$9.75.[2] |
| Specialized Tools and Equipment | For use: a Castroviejo needle holder, vascular dissection forceps, scissors and a scalpel, with 6-0 and 7-0 polypropylene sutures and plastic straws as the vessel surrogate. For construction: pliers and a screwdriver.[2] |
| Version | As described in Cubas 2022 (Cirugía Cardiovascular 29:82–88).[2] |
| Development Team Contact Information | W. Samir Cubas, Department of Thoracic and Cardiovascular Surgery, Edgardo Rebagliati Martins National Hospital, Lima, Peru (wsamircubas@gmail.com).[2] |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Blood vessel | 2 per session | Plastic straw | — | Stand-in for a small-calibre vascular graft; the source names straws as the example surrogate. Each straw is 15 cm long with a 2–3 mm lumen. Held in parallel for side-to-side, or perpendicular for end-to-end and end-to-side, anastomosis.[2] |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Plastic container with lid | 1 | Plastic, 30 × 15 × 10 cm | US$2.50 | Houses the frame and the straws; the lid lets it be carried.[2] |
| Crocodile-type hooks (small) | 4 | Commodity small crocodile clips | US$2.00 | Hold the straws in parallel (side-to-side) or perpendicular (end-to-end, end-to-side).[2] |
| Galvanized fine wire | 20 cm | Galvanized wire | US$0.25 | Binds each hook to a chrome bracket to form the four "fitted parts".[2] |
| Chrome brackets (curtain-rod type) | 4 | Chrome-plated curtain bracket | US$3.00 | Vertical supports; the upper segment holds a hook, the lower couples to an anchor bolt.[2] |
| Anchor bolts with nut | 8 | 5 mm | US$2.00 | Fasten the four fitted parts to the container floor in the geometry each anastomosis needs.[2] |
Build Instructions
Assembly follows Cubas (2022). Build tools (pliers, screwdriver) are one-off and are not simulator parts; the instruments and sutures needed at session time are listed under Specialized Tools.[2]
Phase 1: Frame subassembly (four "fitted parts")
- Cut the 20 cm galvanized wire into four equal segments.[2]
- For each of the four chrome brackets, loop one wire segment through the bracket's upper segment and through one crocodile hook, then twist it closed with pliers until hook and bracket move as a unit. Each "fitted part" is one hook, one wire binding and one bracket.[2]
- Repeat until four identical fitted parts exist.[2]
Phase 2: Anchor-bolt coupling
- Stand the open container on a flat surface, lid set aside.[2]
- Couple the four fitted parts to the container floor with the 5 mm anchor bolts and nuts: parallel for side-to-side anastomosis, perpendicular for end-to-end and end-to-side.[2]
- Tighten each nut and confirm the frame is rigid and the hooks sit at a consistent height.[2]
Phase 3: Per-session vessel set-up
- Clip two plastic straws (15 cm × 2–3 mm lumen) into the hooks in the orientation for the chosen anastomosis.[2]
- Lay out the Castroviejo needle holder, forceps, scissors and scalpel with 6-0 and 7-0 polypropylene suture, and begin the anastomosis.[2]
Phase 4: Reset
- Discard the used straws and suture tails; keep the frame, bolts, hooks, wire and container for the next session.[2]
Not Suitable For
- Drawing broad performance conclusions — the published evaluation was a single PGY-2 resident; the author states the findings need testing in a larger group of residents.[2]
- Tissue-handling fidelity — the straws stand in for the size and arrangement of vessels, not for vessel-wall properties or bleeding.[2]
References
- ↑ Hero image: GlobalSurgBox Tutorials, End-to-End Vascular Anastomosis. Uploaded to Appropedia by Paola Moreno on 30 July 2024 from a GlobalSurgBox YouTube tutorial; CC-BY-SA-4.0. Used here as a visual analogue of the procedure trained by the Cubas (2022) simulator; the image is not from the Cubas paper itself.
- ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 Cubas WS. Building and training a low-cost and portable vascular anastomosis simulator: Initial experience of a surgical resident. Cirugía Cardiovascular 29 (2022) 82–88. DOI: 10.1016/j.circv.2021.10.007. CC BY-NC-ND 4.0.
- ↑ 3.0 3.1 Cubas WS, Paredes-Temoche A, Dongo WR, Inga KE, Luna-Victoria W, Velarde-Revilla E. Construction and Surgical Training of Coronary Anastomosis on a Low-Cost Portable Simulator: Experience in a Peruvian Multicenter Study. Braz J Cardiovasc Surg 2024. PMID: 39241214. DOI: 10.21470/1678-9741-2023-0479.
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Vascular Anastomosis Simulator (Cubas)". Appropedia. Retrieved June 4, 2026. |