Monitoring and puncturing system for percutaneous dilatational tracheostomy with improved puncture precision

A tracheostomy can be performed either open surgically or endoscopically. For the endoscopic method (the percutaneous dilatational tracheostomy, PDT), the correct choice of the location and orientation at which the skin of the patient is punctured is essential to avoid severe or even fatal complications such as injuries to the thyroid gland, the larynx, the trachea or surrounding blood vessels. Correctly determining the entry point and the trajectory of the puncturing device can be complicated by the patient's anatomy (e.g obese tissue, goiter, short neck, displacement of the trachea), which is why the treating physician often chooses the more time consuming, expensive and invasive open surgical method in these cases.

The invention describes a monitoring and puncturing system configured to enable the physician to reliably identify the correct puncture site, even in patients with a challenging anatomy. A variable magnetic field is generated by a field generator. Magnetic sensors are attached both to the puncturing device and to an endoscopic instrument, which is positioned in the region of the cranial end of the patient's trachea during the procedure. The relative positions of the magnetic sensors - and thus the relative positions of the puncturing device and of the endoscopic instrument - can be reliably determined and visualized to the physician.

Monitoring and puncturing system for facilitating a percutaneous dilatational tracheostomy even in patients with a challenging anatomy

An existing prototype was tested in a trachea model