• Jagtar Singh Heir, Ron Purugganan, Timothy A Jackson, Peter H Norman, Juan P Cata, Alyssa Kosturakis, and Dilip Thakar.
• Department of Anesthesiology & Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: jsheir@mdanderson.org.
• J. Cardiothorac. Vasc. Anesth. 2014 Aug 1;28(4):870-2.

ObjectiveThe objective of this study was to evaluate whether the use of a video double-lumen tube reduced the need for fiberoptic bronchoscopy for (1) verification of initial tube placement and for (2) reverification of correct placement after repositioning for thoracotomy.DesignA single-center retrospective study.SettingThoracic surgery in a medical university hospital.Participants & InterventionsAfter institutional review board approval, 29 patients who underwent thoracic surgical procedures using video double-lumen tubes were included in the final retrospective analysis.Measurements And Main ResultsFor 27 (93.2%) patients, the use of fiberoptic bronchoscopy was not needed either for initial placement or for verification of correct video double-lumen tube placement upon final positioning of the patient. However, for two patients, fiberoptic bronchoscopy was needed: for (1) one patient with severe left mainstem bronchus distortion as a result of a large left upper lobe tumor, and (2) a second patient with secretions that were difficult to clear.ConclusionThis study demonstrates that the video double-lumen tube requires significantly less (6.8%) fiberoptic use for both initial placement and verification of final position, in stark contrast to standard practice in which bronchoscopy is always used to verify final positioning of the double-lumen tube. As opposed to intermittent bronchoscopy, the continuous visualization offered by an embedded camera may confer an added measure of safety.© 2014 Elsevier Inc. All rights reserved.

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