Background: the intubating laryngeal tube (iLTS-D®) is a relatively new device that offers ventilation and secondary fiberoptic intubation. 
Goal of Study: to evaluate the effectiveness and safety of using iLTS-D® for ventilation and trachea intubation of patients without difficult airways. 
Materials and Methods: 70 adults, ASA 1 and 2 patients with normal airway undergoing elective laparoscopic surgery were included. After induction of anesthesia the iLTS-D® was placed with using of an original modified procedure that includes a preliminary determination of the depth of insertion of iLTS-D® (Pict.1) and the subsequent use bimanual jaw thrust maneuver, performed by assistant, during the insertion of iLTS-D® (Pict.2). Then ventilation was checked. An endoscopic assessment of the distal ventilation aperture position was performed in all cases. The endoscopic view was classified as optimal, where the vocal cords were seen at least partially, and non-optimal where the vocal cords were not visualized with normal ventilation. After the endoscopic assessment, the bronchoscope was removed and an attempt of blind trachea intubation was made (Pict.3-4). Then iLTS-D® was removed, leaving the ETT in place (Pict.5).  ‘Time to ventilation’, ‘time to trachea intubation’, success rates and number of attempts of ventilation and intubation, endoscopic view, oropharyngeal leak pressure (OLP) at the level of 60 cm H2O cuff pressure, presence of blood on the device, postoperative sore throat and hoarseness were recorded.
Results and Discussion: insertion of iLTS-D® was successful during the first attempt in 67 patients (95.7%), and during the second attempt in 2 patients (2.9%), insertion failed in 1 case (1.4%). The median ”time to ventilation“ was 21.0 s (interquartile range 15-40 s). The optimal endoscopic view  (1-3 classes) was in 60 cases (85.7%). 
The first attempt of intubation was successful in 55 patients (78.,6%), second attempt – 11 cases (15.7%), intubation failed in 4 cases (5.7%).The median ”time to trachea intubation“ was 20.0 s (interquartile range 12-35 s). The mean OLP was 31.5 cm H2O (interquartile range 26-34 cm H2O). Minor blood stains on iLTS-D® were observed in 5 patients (7.1%). 9 patients (12.8%) complained of a mild sore throat, 2 patients (2.9%) - of hoarseness.
Conclusion: iLTS-D® ensures easy insertion and effective ventilation with high success rate at the first attempt, high oropharyngeal leak pressure superior or comparable to other 2-nd generation EGA, and low airway morbidity. The high success rate of the first intubation attempt and the overall success rate of intubation is comparable to that of other intubating EGA.


10 / Efficiency and safety of ventilation and intubation through the intubating laryngeal tube: a pilot study.