Click here to view a video demonstration of the Open Appendectomy produced by the School of Surgery Yorkshire and the Humber England

Appendectomy Simulation

The appendectomy simulator was primarily developed to test the student Surgical Technologist's ability to pass sutures and instruments, anticipate the progression of the procedure and deal with the contaminated specimen, among other tasks.

This simulator helps to create an environment where various surgical instrumentation can be applied. The instruments and sutures used on the simulator are the same used in an actual appendectomy procedure.

The following directions are intended to be used as a guide for the instructor. Any vairation of the procedure may be made as needed.

Instructions

1. Attach the simulator to the operative field using the Velcro patch.
   (Be sure that the side of the simulator with the DELLETEC label is facing toward the head of the bed.)
2. Drape the simulator in the usual manner.
3. Make a skin incision. Incise the adipose tissue and retract with Army/Navy retractors.
   Clamp, cut and tie the vessels in the adipose tissue.
4. Dissect through the adipose layer, and grasp the fascia with two kellys and incise with the deep knife.
   Gelpi self-retaining retractors can also be used.
5. Dissect through the muscle. Pick up the posterior fascia with two kellys, incise with the deep knife and extend the incision.
6. Grasp the peritoneum with two kellys, incise with the deep knife and extend the incision.
7. Grasp the appendix with a Babcock clamp. (Cultures could be taken at this time.) Crush the base of the appendix with a clamp and place an O-Chromic tie at the base.
8. Excise the appendix. Pass the specimen with the dirty instruments to the technologist. Place a purse string suture around the stump of the appendix. Tighten the purse string stitch, tie and cut.
9. Close the peritoneum with suture of choice. (Drains may be placed at this time.)
10. We recommend that the fascia be closed using an inturrupted stitch with an eyed needle. This gives the student the opportunity to practice threading and passing eyed suture.
11. Close the adipose and skin layers in the usual fashion. Skin staples or steri-strips may be used if desired.