Visual Bronchial Blocker

The VBB has a larger outer diameter (3.4 mm) than conventional bronchial blockers because of its integrated camera. High-quality comparative evidence of the VBB versus DLT for VATS is absent. The visual bronchial blocker integrates a micro-camera at the distal tip, providing real-time forward visualisation and eliminating the need for a separate fibreoptic bronchoscope. The VBB features adjustable angulation for easier passage through the vocal cords, an integrated blocking balloon, and continuous intraoperative monitoring capability. Conventional bronchial blockers present practical challenges including difficult positioning, poor malleability, and dependence on a separate fibreoptic bronchoscope. The mechanical stimulus of the larger VBB traversing the glottis could still contribute to postoperative symptoms despite its softer shaft. For right-sided VBB placement, correct positioning is additionally verified by visual confirmation of the right upper lobe orifice. The VBB is advanced 15–20 mm beyond the carina into the target main bronchus under direct visual guidance.