Development and Design of a New Sonography Rigid Bronchoscopy and Corollary Vacuum-assisted Biopsy Device System_Journal of Biomedical Engineering

Authors：

ZHANGLi ¹ , ZHANGXiangdong ² ,  TANXiaojiang ¹ , ZHANGRuixiang ³ , DONGFuwen ³

1. Huiqiao Department, Nan Fang Hospital, Southern Medical University, Guangzhou 510515, China;
2. School of the First Clinical Medicine, Southern Medical University, Guangzhou 510515, China;
3. School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China;

Corresponding author：

TANXiaojiang, Email: txjzdk@126.com

Keywords：

mediastinal lesion; ultrasonic-probe with ultrasound catheter; rigid bronchoscopy; vacuum-assisted biopsy device

DOI：

10.7507/1001-5515.20140035

Video：

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The present study was to develop and design a new sonography rigid bronchoscopy and corollary vacuum-assisted biopsy device system with less injury and complication. The system combined ultrasonic-probe with ultrasound catheter, a new medical ultrasound technique, and rigid bronchoscopy (RB) which is improved with an auxiliary vacuum-assisted biopsy device. The principle of the device is vacuum suction and rotary knife. The reduced outer diameter of the RB led to less pain and lower complications for the patient. With the help of ultrasonic-probe (30 MHz), lesions and blood vessels can be identified clearly and unintentional puncture and damage to blood vessels can be avoided. Plenty of lesions can be obtained quickly through the vacuum-assisted biopsy device without getting puncture needle in and out repeatedly. The novel endobronchial sonography rigid bronchoscopy and matched vacuum-assisted biopsy device has many remarkable advantages. It can enlarge the applied range of the RB from endobronchial to mediastinal lesions, avoiding unintentional puncture of vessels. Obtaining multiple samples with a higher accuracy rate than that by other sampling techniques, minimizing operation time, alleviating pain and decreasing the complication rate, the system makes up the technical deficiency for the diagnosis and treatment of the mediastinal lesions, to a certain degree.

Citation： ZHANGLi, ZHANGXiangdong, TANXiaojiang, ZHANGRuixiang, DONGFuwen. Development and Design of a New Sonography Rigid Bronchoscopy and Corollary Vacuum-assisted Biopsy Device System. Journal of Biomedical Engineering, 2014, 31(1): 181-186. doi: 10.7507/1001-5515.20140035 Copy

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2.	王欣,黄植蕃,戎铁华,等.纵隔镜的诊断价值及在肺癌分期中的应用[J].中华肿瘤杂志,2002,24(1):74-76.
3.	GUPTA S, WALLACE M J, MORELLO F A Jr, et al. CT-guided percutaneous needle biopsy of intrathoracic lesions by using the transsternal approach:experience in 37 patients[J]. Radiology, 2002, 222(1):57-62.
4.	PROTOPAPAS Z, WESTCOTT J L. Transthoracic needle biopsy of mediastinal lymph nodes for staging lung and other cancers[J]. Radiology, 1996, 199(2):489-496.
5.	王栋,闫绍辉,景晓春,等.CT导引下经皮纵隔肿块穿刺活检的临床应用[J].现代肿瘤医学,2012,20(1):74-77.
6.	蒋立明,唐利荣,邵国良,等.同轴活检技术在CT引导下纵隔内肿块穿刺活检中的临床应用[J].浙江临床医学,2005,7(11):25-26.
7.	WANG K P. Transbronchial needle aspiration and percutaneous needle aspiration for staging and diagnosis of lung cancer[J]. Clin Chest Med, 1995, 16(3):535-552.
8.	孙加源,韩宝惠,张俭,等.超声支气管镜引导下的经支气管针吸活检对肺癌的诊断价值[J].中国肺癌杂志,2010, 13(5):432-437.
9.	WIN T, STEWART S, GROVES A M, et al. The role of transbronchial needle aspiration in the diagnosis of bronchogenic carcinoma[J]. Respir Care, 2003, 48(6):602-605.
10.	NAVANI N, LAWRENCE D R, KOLVEKAR S, et al. Endobronchial ultrasound-guided transbronchial needle aspiration prevents mediastinoscopies in the diagnosis of isolated mediastinal lymphadenopathy:a prospective trial[J]. Am J Respir Crit Care Med, 2012, 186(3):255-260.
11.	NAVANI N, NANKIVELL M, WOOLHOUSE I, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of intrathoracic lymphadenopathy in patients with extrathoracic malignancy:a multicenter study[J]. J Thorac Oncol, 2011, 6(9):1505-1509.
12.	TIAN Q, CHEN L A, WANG H S, et al. Endobronchial ultrasound-guided transbronchial needle aspiration of undiagnosed mediastinal lymphadenopathy[J]. Chin Med J (Engl), 2010, 123(16):2211-2214.
13.	HERTH F J, ANNEMA J T, EBERHARDT R, et al. Endobronchial ultrasound with transbronchial needle aspiration for restaging the mediastinum in lung cancer[J]. J Clin Oncol, 2008, 26(20):3346-3350.
14.	ERNST A, ANANTHAM D, EBERHARDT R, et al. Diagnosis of mediastinal adenopathy-real-time endobronchial ultrasound guided needle aspiration versus mediastinoscopy[J]. J Thorac Oncol, 2008, 3(6):577-582.
15.	胡鸿,陈海泉,陈颖,等.经气管镜超声引导针吸活检术诊断纵隔病变的价值[J].中华肿瘤杂志,2011,33(10):787-790.
16.	耿洁,李全禄,李娜,等.医用超声内窥镜的研究现状与发展趋势[J].中国医学物理学杂志,2010,27(5):2122-2124.
17.	NAKAMURA Y, ENDO C, SATO M, et al. A new technique for endobronchial ultrasonography and comparison of two ultrasonic probes:analysis with a plot profile of the image analysis software NIH Image[J]. Chest, 2004, 126(1):192-197.
18.	HVRTER T, HANRATH P. Endobronchial sonography:feasibility and preliminary results[J]. Thorax, 1992, 47(7):565-567.
19.	KURIMOTO N, MIYAZAWA T, OKIMASA S, et al. Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically[J]. Chest, 2004, 126(3):959-965.
20.	陈正贤,郭纪全,李静,等.硬质支气管镜临床应用182例分析[J].中国实用内科杂志,2005,25(2):123-124.
21.	张杰.现代硬质支气管镜技术的临床应用[J].微创医学,2008,3(4):299-301.
22.	王洪武.硬质气管镜的临床应用[J].中国组织工程研究与临床康复,2008,12(35):6801-6805.
23.	COLT H G, HARRELL J H. Therapeutic rigid bronchoscopy allows level of care changes in patients with acute respiratory failure from central airways obstruction[J]. Chest, 1997, 112(1):202-206.
24.	CHAO Y K, LIU Y H, HSIEH M J, et al. Controlling difficult airway by rigid bronchoscope--an old but effective method[J]. Interact Cardiovasc Thorac Surg, 2005, 4(3):175-179.

1. MEDFORD A R, BENNETT J A, FREE C M, et al. Mediastinal staging procedures in lung cancer:EBUS,TBNA and mediastinoscopy[J]. Curr Opin Pulm Med, 2009, 15(4):334-342.
2. 王欣,黄植蕃,戎铁华,等.纵隔镜的诊断价值及在肺癌分期中的应用[J].中华肿瘤杂志,2002,24(1):74-76.
3. GUPTA S, WALLACE M J, MORELLO F A Jr, et al. CT-guided percutaneous needle biopsy of intrathoracic lesions by using the transsternal approach:experience in 37 patients[J]. Radiology, 2002, 222(1):57-62.
4. PROTOPAPAS Z, WESTCOTT J L. Transthoracic needle biopsy of mediastinal lymph nodes for staging lung and other cancers[J]. Radiology, 1996, 199(2):489-496.
5. 王栋,闫绍辉,景晓春,等.CT导引下经皮纵隔肿块穿刺活检的临床应用[J].现代肿瘤医学,2012,20(1):74-77.
6. 蒋立明,唐利荣,邵国良,等.同轴活检技术在CT引导下纵隔内肿块穿刺活检中的临床应用[J].浙江临床医学,2005,7(11):25-26.
7. WANG K P. Transbronchial needle aspiration and percutaneous needle aspiration for staging and diagnosis of lung cancer[J]. Clin Chest Med, 1995, 16(3):535-552.
8. 孙加源,韩宝惠,张俭,等.超声支气管镜引导下的经支气管针吸活检对肺癌的诊断价值[J].中国肺癌杂志,2010, 13(5):432-437.
9. WIN T, STEWART S, GROVES A M, et al. The role of transbronchial needle aspiration in the diagnosis of bronchogenic carcinoma[J]. Respir Care, 2003, 48(6):602-605.
10. NAVANI N, LAWRENCE D R, KOLVEKAR S, et al. Endobronchial ultrasound-guided transbronchial needle aspiration prevents mediastinoscopies in the diagnosis of isolated mediastinal lymphadenopathy:a prospective trial[J]. Am J Respir Crit Care Med, 2012, 186(3):255-260.
11. NAVANI N, NANKIVELL M, WOOLHOUSE I, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of intrathoracic lymphadenopathy in patients with extrathoracic malignancy:a multicenter study[J]. J Thorac Oncol, 2011, 6(9):1505-1509.
12. TIAN Q, CHEN L A, WANG H S, et al. Endobronchial ultrasound-guided transbronchial needle aspiration of undiagnosed mediastinal lymphadenopathy[J]. Chin Med J (Engl), 2010, 123(16):2211-2214.
13. HERTH F J, ANNEMA J T, EBERHARDT R, et al. Endobronchial ultrasound with transbronchial needle aspiration for restaging the mediastinum in lung cancer[J]. J Clin Oncol, 2008, 26(20):3346-3350.
14. ERNST A, ANANTHAM D, EBERHARDT R, et al. Diagnosis of mediastinal adenopathy-real-time endobronchial ultrasound guided needle aspiration versus mediastinoscopy[J]. J Thorac Oncol, 2008, 3(6):577-582.
15. 胡鸿,陈海泉,陈颖,等.经气管镜超声引导针吸活检术诊断纵隔病变的价值[J].中华肿瘤杂志,2011,33(10):787-790.
16. 耿洁,李全禄,李娜,等.医用超声内窥镜的研究现状与发展趋势[J].中国医学物理学杂志,2010,27(5):2122-2124.
17. NAKAMURA Y, ENDO C, SATO M, et al. A new technique for endobronchial ultrasonography and comparison of two ultrasonic probes:analysis with a plot profile of the image analysis software NIH Image[J]. Chest, 2004, 126(1):192-197.
18. HVRTER T, HANRATH P. Endobronchial sonography:feasibility and preliminary results[J]. Thorax, 1992, 47(7):565-567.
19. KURIMOTO N, MIYAZAWA T, OKIMASA S, et al. Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonary lesions endoscopically[J]. Chest, 2004, 126(3):959-965.
20. 陈正贤,郭纪全,李静,等.硬质支气管镜临床应用182例分析[J].中国实用内科杂志,2005,25(2):123-124.
21. 张杰.现代硬质支气管镜技术的临床应用[J].微创医学,2008,3(4):299-301.
22. 王洪武.硬质气管镜的临床应用[J].中国组织工程研究与临床康复,2008,12(35):6801-6805.
23. COLT H G, HARRELL J H. Therapeutic rigid bronchoscopy allows level of care changes in patients with acute respiratory failure from central airways obstruction[J]. Chest, 1997, 112(1):202-206.
24. CHAO Y K, LIU Y H, HSIEH M J, et al. Controlling difficult airway by rigid bronchoscope--an old but effective method[J]. Interact Cardiovasc Thorac Surg, 2005, 4(3):175-179.

Journal of Biomedical Engineering

Development and Design of a New Sonography Rigid Bronchoscopy and Corollary Vacuum-assisted Biopsy Device System

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