Successful left‐sided one‐lung ventilation using two Arndt endobronchial blockers in a patient with right tracheal bronchus

Abstract

SummaryOne‐lung ventilation is frequently performed during operations that require a transthoracic approach. Although a double‐lumen tube is the most common device used for definitive lung isolation, if a patient has a tracheobronchial anomaly, such as tracheal bronchus, or if an anaesthetist cannot apply the double‐lumen tube due to specific surgical manipulation requirements, a bronchial blocker can be an alternative. In some cases where lung isolation cannot be achieved by using a DLT or one bronchial blocker, the use of dual bronchial blockers can be a feasible option. We present the case of successful left‐sided one‐lung ventilation using two Arndt bronchial blockers in a patient with a right upper lobe tracheal bronchus who underwent robotic oesophagectomy. We conducted a bi‐luminal (intraluminal and extraluminal) insertion technique for both precise placement of the blockers and also enabling adequate ventilation. Dual blockers with bi‐luminal insertion can be an alternative in complicated cases.