Pediatric Lung Isolation for Robotic Lobectomy: A Combo Approach for Bronchial Blocker Placement

Pediatric one-lung ventilation (OLV) is always challenging for the anesthesiologist. Despite a plethora of options in the present era, there still remains a concern regarding the choice and success of the modality to isolate the lungs in the pediatric age group especially for thoracoscopic procedures. Bronchial blockers provide an effective way to achieve OLV in patients below 6 years. With smaller-sized endotracheal tubes (ETTs) being used in this age group, a physical check of the fit between the equipment (bronchoscope and the blocker inside the ETT) is strongly recommended. In the present case report of a 3.5-year-old child requiring lung isolation for robotic-assisted thoracoscopic surgery, we went a step ahead by using this entire assembly to intubate the patient. This innovative combo approach was chosen considering the anticipated struggle with manoeuvring the two components together. It was quick and safe in terms of decreased airway manipulation of pediatric airway.