Methods of chest tube insertion

A method of inserting a chest tube into a chest cavity of a patient, comprising:

• applying a sterile cleaning and draping to a surgical site on the patient;
• administering a local anesthesia to the patient within the boundaries of the surgical site;
• inserting and advancing a needle over a top edge of a target rib of the patient into a pleural space of the chest cavity until air or fluid is aspirated;
• inserting a guidewire into the pleural space of the chest cavity via the needle, and removing the guidewire from the inserted guidewire;
• dilating a tract that runs along the guidewire and advancing a chest tube insertion apparatus along the guidewire, the chest tube insertion apparatus comprising a sheath having a stylet installed in the sheath, the sheath including a sheath body having a distal end and a proximal end, a sheath lumen defined axially through the sheath body from the distal end to the proximal end of the sheath, a tapered tube clamp at the distal end of the sheath body, the stylet having a distal tip and a proximal tip, and a stylet lumen defined axially through the stylet from the distal tip to the proximal tip of the stylet;
• translating the chest tube insertion apparatus along the guidewire until the distal tip of the stylet is located within the pleural space of the chest cavity of the patient, and removing the guidewire;
• positioning the chest tube insertion apparatus in the pleural opening oriented to a desired direction for chest tube insertion, and removing the stylet;
• inserting a chest tube through the lumen of the sheath body to a desired distance past the tapered tube clamp at the distal end of the sheath body;
• connecting an end of the chest tube that remains outside of the patient to a suction operated pleural drainage system and applying suction to the chest tube at an appropriate negative pressure for reflating a lung of the patient or evacuating fluid from the chest cavity;
• confirming the chest tube is in a desired position and the chest tube is functional;
• and
• removing the chest tube insertion sheath from the chest tube while the chest tube remains in place inside the body and while suction to the chest tube is maintained.

A method of inserting a chest tube into a chest cavity of a patient, comprising:

• advancing a chest tube insertion apparatus into a patient, the chest tube insertion apparatus comprising a sheath having a stylet installed in a lumen in the sheath, the sheath having a distal end and a proximal end;
• removing the stylet from the sheath once the sheath is in a desired location and orientation;
• inserting a distal end of a flexible bronchoscope into a chest tube and advancing the chest tube on the bronchoscope to the proximal end of the bronchoscope;
• inserting the distal end of the bronchoscope into the sheath and advancing the distal end of the bronchoscope through the sheath into the patient's body to a desired location;
• advancing the chest tube over the bronchoscope and into the sheath to a desired location for the chest tube;
• withdrawing the bronchoscope from the sheath and chest tube, leaving the chest tube in place in the sheath and inside the patient's body;
• confirming the chest tube is in a desired position and the chest tube is functional;
• and
• removing the chest tube insertion sheath from the chest tube while the chest tube remains in place inside the body and while suction to the chest tube is maintained.