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Modified Beef Tongue Model for Fourth-Degree Laceration Repair Simulation

Illston, Jana D. MD; Ballard, Alicia C. MD; Ellington, David R. MD; Richter, Holly E. PhD, MD

doi: 10.1097/AOG.0000000000001908
Contents: Procedures and Instruments

BACKGROUND: An existing model for fourth-degree laceration repair uses beef tongue with plastic or vinyl tubing. This modified model substitutes beef tripe for the anal mucosa and chicken leg muscles for the anal sphincter muscle analogs to create a realistic model.

METHOD: Tripe is tunneled through the body of the trimmed beef tongue and sutured like an ostomy to simulate the anal canal. The tongue is incised toward the tripe “anal canal.” Chicken leg muscles are tunneled from the incision out to the cut edges of the beef tongue to create anal sphincter muscle analogs. Procedures can be repeated on the opposite side. Two double-sided models can be made per tongue.

EXPERIENCE: The model can be refrigerated or frozen and thawed before use. A fourth-degree laceration can be cut immediately before use. Materials were obtained at a local supermarket for $5–7 per half-tongue, double-sided model. Residents responded positively to the model and stated that animal tissue provided realistic haptic simulation.

CONCLUSION: The modified beef tongue model utilizing tripe and chicken leg muscles as anal mucosa and anal sphincter muscle analogs, respectively, provided excellent perceived haptic fidelity. Moreover, it is an innovative, inexpensive, and well-received teaching tool to augment resident education.

The modified beef tongue model with tripe and chicken components has excellent haptic fidelity and is an affordable teaching tool for obstetric laceration repair.Supplemental Digital Content is Available in the Text.

Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery, University of Alabama at Birmingham, Birmingham, Alabama.

Corresponding author: Jana D. Illston, MD, 1700 6th Avenue S, Suite 10382, Birmingham, AL 35212; email:

Financial Disclosure The authors did not report any potential conflicts of interest.

The video associated with this article was presented at the meeting of the Society of Gynecologic Surgeons, April 10–13, 2016, Palm Springs, California, and at the American College of Obstetricians and Gynecologists Districts IV and VII Annual Meeting, October 14–16, 2016, White Sulphur Springs, West Virginia.

The authors thank Dr. Isuzu Meyer for her help in the filming of the video and Cara Harris for her assistance with manuscript assembly as part of her participation in the National Science Foundation-sponsored Alabama Louis Stokes Alliances for Minority Participation Summer Research Internship Program.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.