ez bloker

Usage of EZ blocker on bilateral videothoracoscopic sympathectomy

Senior Editor;

Videothoracoscopic sympathectomy is used for several vasomotor diseases , the most common and successful field of application is hyperhidrosis.

Videothoracoscopic sympathectomy is a minimal invasive procedure with low risk of complication. It needs a short while of time and patients dont need to be hospitalized.These benefits let the physicians practice safely.

Unilateral lung ventilation (ULV) is mandatory for accomplishing the procedure in a short while.

. Double lumen endotracheal tube (DLET) is generally used for Endotracheal intubation.

Usage of DLETs  cause some disadvantages. Bronchoscopy is commonly needed for proper placement of the tube. . DLETs are thicker then the normal tubes, placement of the tubes are extra hard for patients with difficult airway.Indeed postoperative tracheal rupture and hoarseness cases are more common.  . DLETs also may need to be replaced with single lumen tubes for patients who need postoperative intubation. .On some operations like bilateral thoracoscopic smypathectomy , both lungs need to be deflated in turns. technical problems like tube changes during the operation show up and lengthen the operation time. Bronchial blockers ,used for the same purpose are placed with single lumen tubes.Broncoscopy is again needed for the correction of the placement. .  Despite its disadvantages ,bronchial blockers present similar performance comparing DLETs.

. EZ bloker (®) (EZ; AnaesthetIQ BV, Rotterdam, Hollanda), has been started to get used lately.

.It provides bilateral lung ventilation without any additional manipulation.

). It has two extensions sitting on the trakeal bifurcation which lets you deflate the desired lung by inflating its cuff  . (Figure 1) It can be placed through a single lumen endotracheal tube.

Bronchoscope  may be needed for verification of placement.

EZ blocker may only be used to block the mainstem bronchus and to achieve a total lung collaps. There is a chance that two extensions might stick together and enter in the same mainstem brochus which can be determined easily. Unlike the bronchial blocker selective block of a lobe is not possible. . EZ blocker can be placed by physician blindly when needed by an emergency case, saving alot of time.

.It is also provides quite simplicity and comfort when both lungs need to be inflated and deflated in turns.

Vegh T. and his friends have used EZ bloker on 10 patients who need SLV

They have underlined the usage of EZ blocker on difficult intubation cases and emergency surgery because of the shortened time of  placement and fast deflation of lung.

Maurisse J. And her friends have compared DLET and EZ blocker on 100 patients who need SLV.

They have measured the placement time of the EZ blocker longer.

Besides sore throat and horseness are found to be fewer among the EZ blocked patients.

Ruetzler K. And his friends have compared EZ blocker and DLET on 40 patients who need SLV.

Although measuring the Placement time of EZ blocker  longer , there hasnt been noticed any differences about lung deflation quality and bronchoscopy results.

We have used EZ blocker on 14 patients who had thoracoscopic sympathectomy operation for hyperhidrosis.In all the cases the placement was verified with bronchoscopy.Successfull SLV was performed during entire operation.

Average Duration of placement for the Ez blocker is 5,1±3,7  minutes.The device has maintained its position within position change.Reentubation hasnt been neccessary when the  deflated lung was changed.

Deflated lung transition was performed only with a simple inflated cuff change.

No hoarseness or sore throat was seen postoperatively.

We have made our mind to declare that EZ blocker has performed SLV perfectly and it is the most appropriate device for the operations with single lung deflation such as throcoscopic sympathectomy.

uğur temel

hacer şebnem yeltepe türk

faruk seçkin yücesoy