title: The use of VivaSight™ single lumen endotracheal tube in morbidly obese patients undergoing laparoscopic sleeve gastrectomy.
abstract: BACKGROUND
  The population of obese patients is progressively growing and bariatric operations are becoming increasingly common. Morbidly obese patients require special anesthetic care and are often considered to be difficult to ventilate and intubate. The VivaSight™ Single Lumen tube is an endotracheal tube with a camera embedded in its tip. The view from the tip appears continuously on a monitor in the anesthesiologist's vicinity. The aim of this study was to assess the VivaSight™ in comparison with conventional endotracheal tube as an aid in the intubation and surveillance of tube position during surgery of obese patients.
  
  
  METHODS
  This is a prospective study of 72 adult obese patients who underwent laparoscopic sleeve gastrectomy. The patients were randomly assigned to be intubated by either the VivaSight™ (40 patients, test group) or a conventional endotracheal tube (32 patients, control group). Data on the patients, the pre-operative airway evaluation, the endotracheal intubation and the post-operative outcome were collected and compared.
  
  
  RESULTS
  The Mallampati scores were significantly higher in the test group than in the control group. Endotracheal intubation took 29 ± 10 and 24 ± 8 seconds using the VivaSight™ and a conventional tube respectively (p = 0.02). Three of the patients in the control group, while none of those in the test group, had soft tissue injury (p < 0.05).
  
  
  CONCLUSIONS
  We found the VivaSight™ SL to be helpful in the endotracheal intubation and continuous surveillance of tube position in morbidly obese patients undergoing laparoscopic sleeve gastrectomy.
authors.affiliation: Department of Anesthesiology, Rambam Health Care Campus, and The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Barak
authors.affiliation: Department of General Surgery, Rambam Health Care Campus, and The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 8 Ha'Aliyah Street, Haifa 35254, Israel.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Assalia
authors.affiliation: Department of General Surgery, Rambam Health Care Campus, and The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 8 Ha'Aliyah Street, Haifa 35254, Israel.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Mahajna
authors.affiliation: Department of General Surgery, Rambam Health Care Campus, and The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 8 Ha'Aliyah Street, Haifa 35254, Israel.
authors.forename: Bishara
authors.initials: B
authors.lastname: Bishara
authors.affiliation: Department of Anesthesiology, Baruch Padeh Medical Center, Poriya, Tiberias, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Braginski
authors.affiliation: Department of General Surgery, Rambam Health Care Campus, and The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 8 Ha'Aliyah Street, Haifa 35254, Israel.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Kluger
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies
keywords: Airway; Anesthetic techniques; Bariatric complications; Equipment; Fiber-optic; Mechanical; Morbid obesity; Surgery; Ventilation