This document discusses bronchoscopy procedures and areas for improvement. Bronchoscopy involves inserting a viewing tube into the lungs to evaluate and treat lung diseases. It allows diagnosis but not direct viewing of lung tissue. The procedures can involve biopsy or bronchial washing to extract samples. Improvement areas include more ergonomic and lightweight x-ray protection, smaller endoscopes, reusable tools, and efficient sterilization methods. A proposed solution is an electromagnetic system that moves a probe in the lungs guided by preoperative and intraoperative images for better navigation and smaller, more maneuverable tools.

1. Bronchoscopy
Procedure & Medical Needs
Image Guided Surgery
Student group
Eduard Cortés
Phalgun Chowdhary
Suhanyaa Nitkunanantharajah
Thomas Schromm
Supervisors
Dr. J. Traub
Dr. M. Friebe
Dipl. Phys. P. Matthies
Lecture
Image Guided Surgery (IN2286)
Summer term 2015
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2. Introduction
•
Definition
•
Clinical Observation
•
Medical Needs & Analysis
•
Solution
Outline
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3. Introduction
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4. Introduction
Clinical Field:
Bronchoscopy

5. Introduction
Prof. Dr. med. Hubert Hautmann
Head of department
Pneumology
Klinikum rechts der Isar
Technische Universität München

6. Definition
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7. ✦ Endoscopic examination of the lungs and airways
✦ Minimally-invasive procedure during which a
viewing tube is used to evaluate a patient's lung
and airways
✦ Used for both diagnosis and treatment of lung
related diseases
✦ Does not allow direct viewing & inspection of lung
tissue
Definition
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8. Observations
&
Pain-Gain Analysis
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9. Procedure II – Bronchial Washing:
extract samples of bacteria in lung
Observations
Procedure I – Biopsy:
extract the cells of lymph nodes
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10. Pain-GainAnalysis
PAIN GAIN
DOCTOR
• Heavy lead vest
• Uncomfortable position
• Patient is moving (spasms)
• Radiation exposure
• Large diameter bronchoscope
• Fast procedure
• Good communication
NURSE
• Heavy lead vest
• Uncomfortable position
• Redundant movements
• Radiation exposure
• Fast procedure
• Clear instructions
PATIENT
• Radiation exposure
• Uncomfortable procedure (spasms, local
sedation)
• Fixation
• Large diameter bronchoscope
• Local sedation (safer, shorter recovery
time)
HOSPITAL
ADMINISTRATION
• Legal problems (binding)
• Cost single-use instruments
• Efficient procedure
HEALTHCARE
PROVIDERS
• Competitors
• Single-use instruments mean more
sales
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11. Medical Needs
&
Analysis
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12. ✦ More ergonomic and light weight X-Ray Protection
✦ Smaller endoscopes to improve accessibilty of airways
✦ Reusable tools and instruments
Find an easier and cheaper way to sterilize tools
Medical Needs
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13. ✦ More efficient, more mobile and more ergonomic arrangement of the OR
Medical Needs
✦ Ceiling mounted screens
✦ Efficient placement of imaging material on displays
✦ Ceiling mounted shelfes
✦ Wireless communication between the devices
✦ More comfortable and ergonomic working position
for doctor and nurse
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14. ✦ Better navigation and image support
Medical Needs
Self-acting, probe-guiding set-up in bronchoscopy
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15. Solution
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16. Solution
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17. Key features of the solution
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✦ Electromagnetic system moves a probe located in the body in the 3D (x, y, z axis)
✦ The system is self-acting: computer uses a preoperative high precision image
registered with the intraoperative image for the guidance
✦ Allows smaller size, better access to remote locations and higher manoeuvrability
✦ High potential  broad application field

18. Thank You!