Endobronchial tubes – a case for re‐evaluation

Summary An endobronchial tube (Macintosh‐Leatherdale) was used to secure the airway for a tracheal resection and end‐to‐end anastomosis. This lung separation device enabled insertion of both a fibreoptic bronchoscope and a tube exchange catheter. These were required after the trachea was transected and re‐anastomosis proved surgically difficult. The airway exchange catheter allowed for jet ventilation and later a tube change when an emergency occurred. Options and management issues for tracheal surgery and lung separators are discussed. A case is made for a re‐evaluation of endobronchial tubes both as a useful conduit for modern airway instruments and as an alternative to small double‐lumen tubes for the increasing population of obese patients weighing > 100 kg, requiring thoracic surgery.