• Jay B Brodsky.
• Department of Anesthesiology, Stanford University School of Medicine, Stanford, California 94305, USA. jbrodsky@stanford.edu
• Curr Opin Anaesthesiol. 2004 Feb 1; 17 (1): 7-11.

Purpose Of ReviewThe debate continues as to whether a fiberoptic bronchoscope must be used to position a double-lumen tube. This review supports the argument that although bronchoscopy is extremely helpful, it is not always needed for the routine placement of left double-lumen tubes.Recent FindingsSeveral recent clinical reports have demonstrated that an experienced anesthesiologist can safely and consistently position double-lumen tubes without bronchoscopic assistance. In order to do so several important factors must be considered. These include the appropriate choice of tube (left or right), size of tube, and endpoint for the depth of insertion.SummaryAlthough bronchoscopy is useful, no double-lumen tube positioning method is fail-safe. The choice of which approach to use, 'blind' versus fiberoptic bronchoscope-assisted, is influenced by many factors. Operator experience with any method increases the likelihood of success. A fiberoptic bronchoscope is not always needed for left double-lumen tube placement.

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