TRACHIO- BRONCHIAL TUBE FOR ONE ?LUNG VENTILATION

THE IDEA IS SIMPLE .IT IS A LEFT TRACHIO ? BRONCHIAL TUBE IN WHICH THE BRONCHIAL PART IS DIRECTED TO THE LEFT. IT HAS A SINGLE LUMEN WITH A TRACHEAL OPENING ABLE TO VENTILATE THE RIGHT LUNG AND A BRONCHIAL OPENING TO VENTILATE THE LEFT LUNG. A ROUNDED DIAPHRAGM ATTACHED TO THE CARINAL END CONTROLS EITHER LUNG VENTILATION. IT IS CONTROLLED BY TWO ELASTIC THREADS ( RIGHT AND LEFT ) EMBEDDED IN THE WALL OF THE TUBE AND ATTACHED TO THE APEX OF THE DIAPHRAGM.A STYLET IS INTRODUCED TO CORRECT THE LEFT DEVIATION OF THE BRONCHIAL PART AFTER STRETCHING THE RIGHT THREAD TO MAKE THE TUBE COMPLETELY PATENT. AFTER INTRODUCTION OF THE TUBE INTO THE TRACHEA, THE STYLET IS THEN WITHDRAWN. BY LOOSENING THE RIGHT THREAD THE DIAPHRAGM RETURNS TO ITS NORMAL POSITION.ALLOWING PATENCY OF BOTH RIGHT AND LEFT OPENINGS AND HENCE PATENCY OF BOTH LUNGS. A HOOK IS PRESENT AT THE CARINAL END TO HELP ADEQUATE POSITIONING OF THE TUBE. THE HOOK IS ENDED BY A ROLLED BALL TO MINIMIZE INJURY OF THE TRACHEAL MUCOSA AND THE STYLET HELPS IN MINIMIZING THE ANGLE BETWEEN THE BRONCHIAL TUBE AND THE HOOK. THE TUBE IS INTRODUCED GENTLY UNTIL IT REACHES THE CARINA AND THE HOOK SETTLES ON IT. IN THE NEUTRAL POSITION OF THE DIAPHRAGM BOTH LUNGS ARE EVENLY VENTILATED. PULLING ON EITHER THE RIGHT OR LEFT THREAD MOVES THE DIAPHRAGM TO OCCLUDE RIGHT OR LEFT LUNG RESPECTIVELY.