New Device Shortens Chest-Tube Insertion Time

A novel one-handed thoracic portal opener dramatically shortens chest-tube insertion procedure time when treating pneumothorax.

Developed by researchers of the BioDesign team at the Hebrew University (HUJI; Jerusalem, Israel) and Hadassah Medical Center (Jerusalem, Israel), the ThoraXS is a closed, knife-shape device that permits fast penetration of the pleural space, and a mechanical opening mechanism that enables the rapid opening of a gateway in the thorax through which a chest tube (or intercostal drain) can be quickly inserted, usually in the area under the axilla where damage to internal organs can be avoided.

In traumatic pneumothorax, larger bore tubes are inserted than in spontaneous pneumothorax, which are connected to a one-way valve system that allows air to escape, but not to re-enter, the chest. This may include a bottle of water that functions as a water seal, or a unidirectional Heimlich valve. Patients are evacuated with the chest tube in place for further treatment in a hospital. Development of the ThoraXS was initiated following the recent wave of knifing terrorist attacks in Israel.

“The current procedure involves two steps; a fast needle decompression of the cavity, followed by a slow, 15-minute procedure to insert the chest tube and secure the lung permanently,” said device co-developer Ariel Drori, MD, an internal medicine expert at Hadassah Medical Center. “This is a very laborious and technically difficult procedure, leading caregivers to neglect the second step in favor of rapid evacuation from the scene to the hospital.”

“Our students responded to terror attacks by developing life-saving medical devices, an approach that is the very essence of our BioDesign medical innovation program,” said Prof. Yaakov Nahmias, PhD, director of the HUJI BioDesign center for bioengineering. “ThoraXS is a life-saving innovation that exemplifies our commitment to helping the local and global communities through practical research and development projects.”

Pneumothorax is a medical emergency resulting from an abnormal collection of air or gas in the pleural space that causes an uncoupling of the lung from the chest wall, causing it to collapse and resulting in suffocation. A traumatic pneumothorax may result from either blunt trauma (such as an explosion) or a penetrating injury to the chest wall.

Related Links:
Hebrew University
Hadassah Medical Center