Left main bronchus injury incurred during video double-lumen endobronchial tube intubation: A case report

Endotracheal intubation is a basic skill performed by healthcare professionals worldwide which is generally considered safe and effective. Nevertheless, this method is associated with some risks that, can result in significant issues. Double-lumen endobronchial tubes (DLTs) are commonly used in thoracic surgery as the preferred tool for one-lung ventilation. In recent years, visualization technology has highlighted the advantages of video double-lumen endobronchial tubes (VDLTs), leading to their increased clinical use. Nevertheless, the potential safety hazards remain unaddressed. Herein, we report a case of left main bronchus injury during VDLT intubation in a 59-year-old female patient undergoing right upper and lower lobe resection. After smooth intubation with a 35-Fr VDLT, position was confirmed by fiberoptic bronchoscopy. At the end of surgery, a 2-cm laceration was found on the membranous portion of the left main bronchus. The injury was repaired with 4-0 absorbable sutures, and the patient recovered uneventfully and was discharged on day 5. Such complications should be published to share experiences and raise awareness among anesthesiologists and thoracic surgeons, emphasizing that even with advanced visualization, airway injury remains a possible risk factor.