Combined Use of a Fiberscope and Fuji Uniblocker for Removal of Retained Bronchial Tissue Glue After Repair of a Disrupted Left Main Bronchus

• Published in: Seminars in cardiothoracic and vascular anesthesia 2019-09, Vol.23 (3), p.333-337
• Main Authors: Khidr, Alaa Mohamed, El Tahan, Mohamed R., Doyle, D. John, Aljehani, Yasser Maher
• Format: Article
• Language: English
• Subjects: Adult; Bronchi - injuries; Bronchi - surgery; Bronchoscopes; Bronchoscopy - instrumentation; Bronchoscopy - methods; Fiber Optic Technology; Foreign Bodies - surgery; Humans; Intubation, Intratracheal - methods; Male; Tissue Adhesives
• ISSN: 1089-2532; 1940-5596
• DOI: 10.1177/1089253218792056

We describe the novel combined use of a fiberoptic bronchoscope and a Fuji Uniblocker placed outside the endotracheal tube (ETT) for removal of a retained BioGlue polymerized tissue fragment (2.8 × 0.8 cm) from the right main bronchus (RMB). The patient was a trauma victim who presented with a diffuse axonal injury, cervical spine and maxillofacial injuries, and a flail chest, and the procedure we describe took place following the surgical repair of a disrupted left main bronchus. Endoscopic retrieval using different sizes of grasping forceps and a Dormia basket failed to remove the foreign body (FB). Under combined GlideScope videolaryngoscopic and bronchoscopic guidance, a 9.0 F Uniblocker was introduced outside the ETT, placed into the RMB beyond the FB, initially inflated, and then gradually increased in volume during withdrawal from the RMB into the trachea so as to trap the FB between the tip of the ETT and the blocker balloon. The ETT, bronchoscope, blocker catheter, and the FB were then removed from the glottis as a single unit. The FB was then removed using Magill forceps with the aid of a GlideScope. We conclude that the combined use of a GlideScope, bronchoscope, and an Uniblocker placed outside the ETT can be an effective method for removal of a retained FB.