Robertshaw Double Lumen Tubes: A Reappraisal Thirty Years On

Abstract

A propsective analysis oj 100 successive intubations with Robertshaw tubes in patients submitted jor routine thoracic surgery is presented. Clinical guidelines jor intubation were used as the protocol. Tube position was judged on clinical assessment only and not confirmed with jibreoptic bronchoscopy. In approximately 60% oj cases the tubes were judged to be correctly placed on initial introduction. In 20-30% oj cases, minor and simple adjustments were required to achieve suitable conditions jor one lung anaesthesia. In no case did it prove impossible to achieve conditions adequate jor surgery. Common problems related to the endobronchial portion oj tubes entering the wrong bronchus, being inserted too jar, or not jar enough. Two oj six episodes oj hypoxaemia related to minor problems with tubes and were easily corrected. The experience is compared with that oj other workers. The pertinence and implications oj the experience and the data to the training oj personnel in the techniques oj one-lung ventilation and the juture oj Robertshaw tubes are discussed. It is concluded that the good practical results achieved are specifically related to the Robertshaw design and the material oj manujacture.

Pitfalls of Double Lumen Endotracheal Tube in Prone Position During a Thoracoscopic and Laparoscopic Assisted Esophagectomy (TLAE) : A Sabah Experience

“…The routine use of fiberoptic bronchoscopy in DLT placement can be arguably more costly and time consuming (5,6). However, as demonstrated, it can be an essential tool in the re-intubation of a dislodged DLT particularly in prone position.…”

The Single-connector Technique for Initial Placement of Double-lumen Tubes

“…Possibly because fibreoptic bronchoscopy is not without its limitations 4 , particularly in emergency situations, thoracic anaesthetists must be familiar with the assessment of "correct" DLT position using clinical criteria alone. Also, many anaesthetists elect to use and teach a 'blind' technique 5,6 for initial placement, with a subsequent fibreoptic confirmation of correct position. Most texts recommend that following initial passage of the DLT, the tracheal cuff should be inflated first and both lungs ventilated to confirm bilateral chest movement [7][8][9][10][11] .…”