Surgical Simulation of Bronchoscopy: Introduction

The Introduction to Bronchoscopy module includes extensive videos covering the entire procedure, from holding the scope to navigating the airways, an interactive 3D model showing the tracheobronchial tree and adjoining anatomic structures, and software that teaches the navigation of a bronchoscope in the simulated anatomy. An external view helps users visualize the location of the scope.

Three simulated cases present anatomic and pathologic variations in the upper airway to provide a wide range of experience. A thorough evaluation report is automatically generated every time a user proceeds through a case. All reports are stored in a password-protected database to provide user-specific documentation of training and competency. Items recorded include time to complete the procedure, percent of bronchial segments entered, order of the bronchi visualized, number of scope collisions with the airway wall, aliquots of lidocaine and saline used, and details of the tracheobronchial inspection.

Training Objectives

Upon completion of the Introduction to Bronchoscopy module, the user will be able to:

• Discuss the indications, contraindications, and complications of flexible bronchoscopy and the skills necessary to perform a bronchoscopic examination of the upper and lower airway
• Describe and perform the correct technique for holding and manipulating the bronchoscope
• Discuss the anatomic structures external to the lungs that are relevant to the bronchoscopist and the spatial relationship of the tracheobronchial tree to adjacent anatomic structures
• Describe the procedural steps necessary to perform a complete bronchoscopic examination of the upper and lower airway
• Understand the anatomy of the upper and lower airway as viewed through a bronchoscope
• Visualize the structure of the tracheobronchial tree and identify a variety of endobronchial lesions

Realistic, Educational Aids

The Endoscopy AccuTouch® System delivers realistic, procedure-based content for cognitive and motor skills training. The system
consists of a PC, an interface device with interchangeable anatomy, proxy endoscopes, and software modules for a wide range of training scenarios. Introduction to Bronchoscopy provides several teaching tools for learning the basics of bronchoscopy:

• Road signs, superimposed over the display can be switched on to provide international nomenclature for the pulmonary anatomy, allowing users to orient themselves and solidify their understanding of anatomy and terminology.
• The bronchoscope looks, feels, and handles like a real scope, allowing users to perfect their technique.
• The anatomy is derived from actual patient data and looks and behaves like real tissue; mucus clouds the scope and red-out occurs when the scope collides with airway walls.
• Physiological responses, such as changes in vital signs and coughing result from the user’s actions.
• The simulation contains realistic features such as suction, video capture, and lidocaine and saline dispensing.