Med-Tech Innovation Design


Product EVOLUTION W


hen contemplating a medical device that has been on the market for some fifty years and then realising that this device has not evolved from its original design


means that there has to be potential for improvements. An example of this is with the tracheal tube introducer, commonly known as a bougie. This device is used by anaesthetic and emergency physicians during the placement of an endo-tracheal tube in a difficult airway. It is initially easy to think that the bougie is a simple device. It comprises a length of polymer with a coude angle, which is used as a guide for the endo-tracheal tube, steering a path through the larynx, behind the epiglottis, just avoiding the epiglottis and into the trachea just above the carina or bifurcation.


Need for improvement


Over a number of years incidents have occurred when the bougie has either perforated the trachea causing internal bleeding or damaged the larynx causing the


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The design changes The process started with the development of a soft fluorescent, deflectable tip that has the ability to illuminate the entrance to the larynx when used with a laryngeal handle, thereby greatly assisting passage into the trachea. The coude angle has been set to allow the


September/October 2013 ¦ 37


Neil Cant of Xograph Technologies describes re-designing the bougie used in esophageal dilatation, the design of which had not changed since its introduction approximately five decades ago. What other devices are out there waiting to be improved?


patient levels of discomfort. These incidents have not always been detected immediately, usually due to associated trauma, and there have been a small number of patient deaths. It has generally been accepted that these injuries have been caused by a variety of factors including the difficulty of using previous designs of the device.


Mindful of the experiences of clinicians, and targeting the two main areas of concern, Xograph Technologies set about developing a new range of bougies. The company placed a major emphasis on minimising the risk of injury and trauma while combining ease of insertion and placement of the bougie.


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