Blocker Eye, a novel video-enabled endobronchial blocker for one-lung ventilation during thoracic anesthesia: a...

Conventional endobronchial blockers (EBBs) preserve a single-lumen airway but require fiberoptic bronchoscopy (FOB). Blocker Eye integrates imaging, illumination, steering, and continuous cuff-position monitoring. We evaluated its feasibility for porcine one-lung ventilation (OLV).

Three swine were studied. In Study 1, three board-certified anesthesiologists, all first-time in vivo users, performed 20 placements in one swine in consecutive device blocks: 10 with Blocker Eye and 10 with a conventional FOB-guided EBB. In Study 2, Blocker Eye provided lung isolation during wedge resection and segmentectomy in two swine. Placement time, procedural interruptions, physiology, and airway histopathology were assessed.

In Study 1, OLV-establishment time was shorter with Blocker Eye (median [IQR], 30.9 [20.9-45.3] vs. 60.6 [50.9-71.0] s; exact Mann-Whitney U test, P = 0.009), although the comparison was exploratory and non-independent. In Study 2, both resections were completed, and the operating surgeon considered lung collapse sufficient. No ventilator interruption, rescue FOB, blocker exchange, repositioning, SpO₂ <90%, or high airway pressure requiring intervention occurred; SpO₂ remained 96-100% and end-tidal CO₂ 35-48 mmHg. Grade ≥2 epithelial loss occurred in 5/12 control, 11/12 single-application, and 9/12 repeatedly instrumented fields. Control-adjusted descriptive ISO 10993-6 framework scores were 4.0 for single application and 2.0 for repeated instrumentation. Injury was superficial with mild inflammation, but substantial epithelial loss in one uninstrumented bronchus precluded device-specific attribution.

Blocker Eye enabled OLV with continuous endobronchial monitoring and maintained lung isolation during two resections. These preliminary findings support further device refinement and standardized preclinical safety evaluation before clinical testing.