Korean J Anesthesiol.  2015 Jun;68(3):287-291. 10.4097/kjae.2015.68.3.287.

Transection of a Coopdech bronchial blocker tip during bronchial resection for right upper lobectomy: a case report

• Lee YH
• Yang HM
• Kim HC
• Bahk JH
• Seo JH

• KMID: 2148695
• DOI: http://doi.org/10.4097/kjae.2015.68.3.287

Abstract

A bronchial blocker (BB) is preferred for lung separation in patients with difficult airways. However, BBs, unlike double-lumen tubes, must be placed in the bronchus of the lung being operated on, hence can be damaged by surgical manipulation. Intubation was unexpectedly difficult in this male patient, so a Coopdech BB was placed in the right mainstem bronchus through a single-lumen tracheoscopic ventilation tube for a thoracoscopic right upper lobectomy. During the bronchial resection, however, the distal tip of the BB was transected and pinched in the staple line, so the staple line was partially opened, and the BB was withdrawn into the trachea. The opened bronchial stump was sutured manually under apnea without conversion to an open thoracotomy, and there was no significant air leakage through the suture line. This case underlines the importance of frequently evaluating the position of a BB during lung surgery.

Keyword

Airway management; Bronchi; One-lung ventilation; Thoracoscopy

MeSH Terms

Airway Management
Apnea
Bronchi
Humans
Intubation
Lung
Male
One-Lung Ventilation
Sutures
Thoracoscopy
Thoracotomy
Trachea
Ventilation