Awake Double-Lumen Endotracheal Tube Intubation With Preserved Spontaneous Ventilation for Laparoscopic Repair of a Giant Type IV Hiatal Hernia: A Case Report.
Jiaqi Ning, Yudong Zhou, Lingling Ding
✦ AI-curated · Sources linked
Case in brief
A 53-year-old woman with a giant type IV hiatal hernia underwent laparoscopic repair. Due to the risk of aspiration and hemodynamic instability, a preoperative strategy involving awake double-lumen tube intubation was employed. The patient received layered topical anesthesia and light sedation, allowing for successful intubation without complications. Neuromuscular blockade was administered only after airway control was established.
What made this case unusual
The use of awake double-lumen tube intubation with preserved spontaneous ventilation in a high-risk patient is noteworthy, particularly given the challenges associated with giant hiatal hernias.
Diagnostic / clinical pearl
Clinicians should consider awake intubation techniques in high-risk patients with giant hiatal hernias to mitigate the risks of aspiration and hemodynamic compromise.
Why it matters
This case highlights the importance of structured airway management strategies in complex surgical scenarios, potentially improving patient safety during anesthesia.