High frequency jet ventilation via a tracheoscope for endobronchial laser surgery

Palliative surgery of malignant endobronchial tumours is associated with various anaesthetic risks. A technique is described using a neodymium:yttrium-aluminium-garnet (Nd:YAG) laser in combination with a special tracheoscope and high frequency jet ventilation (HFJV). The purpose of this technique is to provide separation of anaesthetic and surgical manipulations, good conditions of ventilation and easy access to the lungs for the surgeon. We present our experience with 14 adult patients in whom large endobronchial neoplasms were resected using this technique under intravenous anaesthesia and muscle relaxation. Careful perioperative monitoring and a good outcome allowed us to conclude that this set-up may contribute to improving efficiency and safety of endoscopic resections of endobronchial and/or endotracheal tumours.