The SensaScope^® - A new hybrid video intubation stylet

Abstract

The recently developed SensaScope® is a hybrid intubation endoscope that has been designed and developed according to our clinical requirements for a safe, easy-to-handle, and effective video-assisted intubation. The attribute “hybrid” derives from the fact that the shaft of the instrument is combined by both, rigid and flexible parts. Its S-shaped rigid segment enables a very intuitive handling by one hand only, thus leaving the left hand free to operate a conventional laryngoscope. The tip of the device can be controlled via a steering handle in a similar fashion as fiberoptic endoscopes. Due to these attributes, the SensaScope® became a very versatile and effective tool to master the unanticipated difficult intubation in anesthetized and paralyzed patients. For this reason, in our institution it has been included as the first-line technique into our local failed intubation algorithm. The first clinical experience with the device and its standardized technique of use produced encouraging results; the success rate for novices was found to be at 97% (in 194 of 200 patients) of all intubation attempts in both patients categories: those who were rated as having normal (84.5%) and in those showing difficult intubation conditions (15.5%). The technical development, the way of using the device, the suitable indications, and limitations are discussed here.

Difficult intubation in pregnancy

“…Pentax AWS, Airtraq, Bullard) [20][21][22][23][24][25][26], and video stylets (e.g. Bonfils, Shikani, Levitan, SensaScope) [19,[27][28][29][30]; I prefer in this respect the SensaScope (see acknowledgement). During an ongoing difficult airway event, the first-line device should be used as the first alternative after failed direct laryngoscopy.…”

“…The composition of the cart is a matter of local decisions; however, certain principles should be obeyed. The flexible fiberoptic is explicitly suitable for predicted airway difficulties, but it has certain limitations in the unpredicted difficult intubation situation [19]. Therefore, it should not be viewed as a key component of this cart, in order not to overload it and to make it more difficult to handle.…”

Videolaryngoscopy, the Current Role in Airway Management

“…These devices are equipped with an inbuilt camera and light source [23,24]. Compared to the older versions of videostylets which were designed as rigid linear rods, the newer intubating stylets are often S-shaped and semiflexible with deflectable tips [25,26]. The devices can have an eyepiece at their end or can be attached to monitor to allow watching at the screen.…”

“…Videostylets [23][24][25][26]. The lateral left side of the blade encloses the patient's tongue, moving it medially from the buccal mucosa.…”

A simulated severe difficult airway does not alter the intubation performance with the SensaScope: a prospective randomised manikin study

“…After arrival of the scope tip in mid-tracheal position, the laryngoscope has to be removed and the SensaScope has to be retracted with release of the lever while the tracheal tube is firmly held in place. 17 Although recent tests with the device have proved successful in manikins and in patients, 16,18 a systematic evaluation of its performance in a standardised fashion comparing difficult vs. normal airway anatomy would be valuable. As a control device and to confirm the degree of intubation difficulty, direct laryngoscopy with the Macintosh blade was included in the assessment as well.…”