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A low-cost balloon-based simulator for teaching surgical knot techniques to veterinary students
Juan José Pérez-Rivero1, Georgina Cruz-Gutiérrez2, Ivonne M Heuze de Icaza1,3
1Departamento de Producción Agrícola y Animal, Universidad Autónoma Metropolitana Unidad Xochimilco, Alcaldía Coyoacán, CDMX, México.
Alternatives to Laboratory Animals : ATLA
|April 15, 2026
Summary
Veterinary students learned surgical knot-tying skills effectively using a low-cost balloon simulator. This accessible training tool offers an ethical alternative for developing essential surgical competencies in veterinary education.
Area of Science:
- Veterinary Medicine
- Surgical Education
- Biomedical Engineering
Background:
- Acquiring surgical skills is crucial for veterinary training.
- Ethical, logistical, and financial constraints limit the use of live animals or cadavers for early surgical training.
- There is a need for accessible, animal welfare-oriented surgical training alternatives.
Purpose of the Study:
- To evaluate the effectiveness of a low-cost, balloon-based simulator for teaching basic surgical knot techniques.
- To assess the acquisition of surgical knot-tying skills in undergraduate veterinary students with no prior surgical experience.
Main Methods:
- A cohort of 20 undergraduate veterinary students practiced slip knots, Miller's knots, and transfixation knots using a low-fidelity balloon simulator.
- A structured training protocol was followed.
- Performance was assessed using standardized rubrics, including execution time and a binary success/failure classification based on air leakage.
Main Results:
- All students achieved competency in slip knots and Miller's knots from the 13th repetition onwards.
- Competency in transfixation knots was achieved by the 14th repetition.
- Execution time significantly decreased from the 11th repetition for all knot types, indicating improved technical efficiency.
Conclusions:
- The balloon-based simulator effectively facilitates the acquisition of basic surgical knot-tying skills.
- This simulator represents an accessible, ethical, and effective tool for early-stage surgical training in veterinary education.
