Use of a video fiberoptic bronchoscope to assist double-lumen endobronchial tube intubation in a patient with a difficult airway

In clinical scenarios, the insertion of double-lumen endobronchial tubes (DLTs) is usually employed as a technique of separation of lungs for treatment purposes inclusive of one-lung ventilation for the ease of thoracic surgery. However, in patients with difficult airways, the DLT intubation can be challenging, even with the aid of a fiberoptic bronchoscope (FOB). Insertion of the FOB itself into the trachea may be relatively simple, but the advancement of the DLT with the FOB enclosed in the lumen may be hindered by the abnormal or diseased laryngeal aperture. Herein, we present an alternative approach by using a 5.5-mm video FOB to monitor the DLT rather than using it to act as an introducer to overcome the difficulties often met in DLT intubation in oral cancer patients.