Robertshaw double lumen tubes: a reappraisal thirty years on

A prospective analysis of 100 successive intubations with Robertshaw tubes in patients submitted for routine thoracic surgery is presented. Clinical guidelines for intubation were used as the protocol. Tube position was judged on clinical assessment only and not confirmed with fibreoptic bronchoscopy. In approximately 60% of cases the tubes were judged to be correctly placed on initial introduction. In 20-30% of cases, minor and simple adjustments were required to achieve suitable conditions for one lung anaesthesia. In no case did it prove impossible to achieve conditions adequate for surgery. Common problems related to the endobronchial portion of tubes entering the wrong bronchus, being inserted too far, or not far enough. Two of six episodes of hypoxaemia related to minor problems with tubes and were easily corrected. The experience is compared with that of other workers. The pertinence and implications of the experience and the data to the training of personnel in the techniques of one-lung ventilation and the future of Robertshaw tubes are discussed. It is concluded that the good practical results achieved are specifically related to the Robertshaw design and the material of manufacture.