Tube thoracostomy (TT) insertion can serve as a life-saving adjunct for thoracic trauma. Unfortunately, suboptimal positioning using the open, standard of care technique is associated with complications resulting in impaired TT function. Using a porcine model, we aimed to determine whether a magnetic chest tube positioning system (MCTPS) could be utilized to direct the intrathoracic TT position. Using recently deceased cross-bred domestic swine, we performed TT using our MCTPS and the standard of care open technique. The operator held one magnet outside of the thorax. The second magnet was positioned at the distal aspect of the TT. The operator was tasked with positioning the TT to distinct premarked intra-thoracic locations under blinded conditions. The experiment was video-recorded through an open sternotomy incision. As a control, TT was inserted using the standard of care open technique. The utilization of MCTPS successfully directed TT from one premarked location to another in 4 of 5 attempts (80%). Conversely, the control TT without magnetic guidance failed to navigate the premarked intra-thoracic locations with 0 of 5 attempts successful (p = 0.05). Positional flaws after TT placement are common. We demonstrate the feasibility of the MCTPS as an alternative to traditional hand-guided technique under simulated TT insertion conditions. The MCTPS is possibly superior to the current standard of care technique of TT. Additional studies are needed to develop this emerging technology in humans.
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June 2018
Design Innovation Paper
Magnetic Chest Tube Positioning System
Danuel Laan,
Danuel Laan
Department of Surgery,
Division of Trauma, Critical Care,
and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
e-mail: Laan.Danuel@mayo.edu
Division of Trauma, Critical Care,
and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
e-mail: Laan.Danuel@mayo.edu
Search for other works by this author on:
Trang Ngoc Diem Vu,
Trang Ngoc Diem Vu
Department of Surgery,
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
Search for other works by this author on:
Matthew Hernandez,
Matthew Hernandez
Department of Surgery,
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
Search for other works by this author on:
Henry Schiller
Henry Schiller
Department of Surgery,
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
Rochester, MN 55905
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
200 First ST SW
,Rochester, MN 55905
Search for other works by this author on:
Danuel Laan
Department of Surgery,
Division of Trauma, Critical Care,
and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
e-mail: Laan.Danuel@mayo.edu
Division of Trauma, Critical Care,
and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
e-mail: Laan.Danuel@mayo.edu
Trang Ngoc Diem Vu
Department of Surgery,
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
Matthew Hernandez
Department of Surgery,
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
200 First ST SW,
Rochester, MN 55905
Henry Schiller
Department of Surgery,
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
Rochester, MN 55905
Division of Trauma, Critical Care, and General Surgery,
Mayo Clinic,
200 First ST SW
,Rochester, MN 55905
1Corresponding author.
Manuscript received August 1, 2017; final manuscript received December 16, 2017; published online March 5, 2018. Assoc. Editor: Michael Eggen.
J. Med. Devices. Jun 2018, 12(2): 025001 (3 pages)
Published Online: March 5, 2018
Article history
Received:
August 1, 2017
Revised:
December 16, 2017
Citation
Laan, D., Diem Vu, T. N., Hernandez, M., and Schiller, H. (March 5, 2018). "Magnetic Chest Tube Positioning System." ASME. J. Med. Devices. June 2018; 12(2): 025001. https://doi.org/10.1115/1.4039208
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