TissueDB/Simulators/Bronchoscopy-Guided Percutaneous Dilatational Tracheostomy Simulator (Kattan)

The Bronchoscopy-Guided Percutaneous Dilatational Tracheostomy Simulator is a low-cost trainer for practising bronchoscopy-guided percutaneous dilatational tracheostomy (BG-PDT), built around a hardware-store frame with a low-cost commercial synthetic skin pad and a USB pipe-inspection camera. An ex vivo bovine trachea and the synthetic skin pad are mounted on a PVC-pipe frame and the USB camera stands in for the bronchoscope; two operators use it together — one manipulates the camera to give the bronchoscopic view, the other performs the tracheostomy. It was designed and evaluated by Kattan and colleagues at the Pontificia Universidad Católica de Chile (2019), who report it can be reproduced in almost any intensive care unit.^[1]

1. Cut a PVC pipe (4 cm diameter, 2 mm wall) lengthwise to make a 10 cm half-pipe — the trachea cradle.
2. Cut a second PVC pipe (10 cm diameter, 4 mm wall) lengthwise to make a 24 cm half-pipe — the body frame — and clip an 8 × 8 cm window in it to expose the insertion site.
3. Drill four 5 mm holes in the small half-pipe, each 1 cm from its edges, to accept the zip ties.
4. Fix the small half-pipe to the 20 × 30 cm plastic cutting board.
5. Verify: the small half-pipe is firmly mounted and the four zip-tie holes are clear.

1. Obtain a 20 cm ex vivo bovine trachea (from below the larynx to the carina).
2. Thread zip ties through the drilled holes and fasten the trachea to the small half-pipe, with enough tension to stop horizontal traction during the procedure without collapsing the trachea.
3. Place a foam spacer between the small half-pipe and the trachea if a gap remains once assembled, to raise the trachea for correct assembly.
4. Verify: the trachea is held firmly, is not collapsed, and sits high enough to meet the skin pad.

1. Place the big half-pipe over the small half-pipe and trachea, with the window over the working area.
2. Drive five 2.5 cm screws into the cutting board and three into the big half-pipe; these serve as anchor points for the skin.
3. Lay the 15 × 30 cm synthetic skin pad (6 mm thick, 3-layered) in direct contact with the trachea.
4. Stretch the skin pad and fix it to the screws around the cutting board and the big half-pipe, with enough tension to hold the PVC tubes, skin, and trachea in position.
5. Verify: the skin pad is taut, the trachea is palpable through it, and the assembly is stable.

1. Connect the USB pipe-inspection camera (7 mm diameter, 5 m cable) to a laptop computer.
2. Pass the camera into the trachea to emulate the live bronchoscopic view; during the procedure a second operator manipulates it to provide real-time guidance.
3. Verify: the camera shows a clear view of the tracheal lumen on the laptop.

Loosen the zip ties, reposition the trachea 2.5 cm inferiorly, and reinstall the skin 2.5 cm away so that previously punctured areas stay out of the working space. Each trachea allows 6 iterations and each skin pad 9; reassembly takes about 5 minutes.