Product Review: The Reactor® (Sharp Medical Products)

Introduction

The Reactor^® (Sharp Medical Products) offers a novel approach to the technique of chest tube insertion which has largely remained unchanged for many years.  Open tube thoracostomy has been the standard of care for traumatic hemopneumothorax since the 1960s. While newer, minimally invasive surgical technologies to treat hemopneumothorax have arisen, those technologies may not be readily available in all settings. The device was designed to offer a minimally invasive alternative to open thoracostomy with minimal training and quick skill acquisition.

Details

The Reactor® has a patented rotating and retracting blade that “carves” through tissue as opposed to puncturing with traditional open method.  The oval shaft is designed to better drive  between the rib spaces.  Unique to the Reactor® is its ability to maintain a constant track diameter in the tunnel to pleural space relative to open technique.  In addition the trigger grip design is made to allow for a novel means of blunt dissection through tissue rather than forceful “pushing” with tools or fingers, one now “pulls” the trigger for incremental advancement through tissue.

Data

In a 2018 cadaver study, 1st & 2nd year medical students as well as paramedics with little to no previous chest tube insertion experience compared the Reactor® vs. open method. Study participants indicated a shorter learning curve for the Reactor® and an added benefit that it required less equipment/supplies to complete the procedure.

Researchers at the University of Maryland R. Adams Cowley Shock Trauma Center recognized that chest tube insertion using the Reactor® was slightly faster and associated with a shorter incision length compared to the open method. Participants also rated the ease of use of the Reactor® more favorably compared to the standard open technique.

Prehospital Application

The Reactor® has potential for pre-hospital use. The product touts ease of use and faster insertion time.  We believe that field environments with prolonged transport times or flight crews might benefit from this device.  Tension pneumothoraces that do not respond to needle decompression in the field may be able to be treated more easily with this device. 

Bottom Line

The end result from the Reactor® design is a device that allows medium to large chest tubes to be inserted with a smaller incision and faster than the open technique.  Prehospital potential is present, and the company reports to stay tuned for Generation 2.

(Neither ACEP nor the TEMS Section endorse any products)

Joe Bardinelli
Graduating emergency medicine resident at Conemaugh Memorial Medical Center in Johnstown, PA.  He formerly served as a police officer in Kingsport, TN.