Design of a Novel Video-Assisted Tube Over Tube Rigid Bronchoscope for the Removal of Foreign Bodies from the Bronchi Following Aspiration

Foreign body aspiration (FBA) is a prevalent occurrence in the paediatric population. FBA is when a foreign body (FB) is inhaled accidentally into the airways. The location of the FB may differ according to each patient, but in most cases, the FB is found in the right bronchial tree. FBA symptoms are often misdiagnosed, resulting in late discovery of the obstruction. There is an increase in difficulty to remove a FB, dependent on how long it remains within the airway. This poses a greater risk to the patient, fatality or other serious long-term complications. Currently, FBs are removed using a bronchoscope in conjunction with a pair of forceps. The two types of bronchoscopes used currently are the flexible and rigid bronchoscopes. The rigid scope is preferred for FB removal due to better control and clear visuals of the air way and an array of forceps ends. The costly flexible scope is more difficult to use and is used in cases where radiological findings of a FB are inconclusive. During insertion of the scope, no ventilation is supplied to the patient, posing a high risk of hypoxia. Both instruments require considerable skill and extensive training, limiting the procedure applicability. The difficulty experienced when handling the current instruments and the high risk of hypoxia are motivations for a product redesign. Therefore, this study aims to design and develop a novel video-assisted tube-over-tube rigid bronchoscope to remove foreign bodies from the airways following aspiration, whilst providing constant ventilation and visualisation of the airway. The redesign compromises of several subsystems: the rigid bronchoscope (and attached camera), ventilation connector tube and an uncuffed endotracheal tube (ETT). These subsystems were designed to ensure constant ventilation throughout the insertion of the bronchoscope, whilst providing real-time imaging of the airways. The design incorporated a guiding mechanism to increase the usability further. A testing protocol was performed on a Laerdal airway management ...