Right lung isolation in the prone position using an EZ-Blocker through an armoured endotracheal tube for combined spine and video-assisted thoracoscopic surgery.

Abstract

Surgical correction is the definitive treatment for adolescent idiopathic scoliosis (AIS), but 25% of cases may experience screw migration, risking injury to thoracic structures. Video assisted thoracoscopic surgery (VATS) can visualise malpositioned screws and resolve injury. This report presents a case of an AIS patient who underwent prone VATS for simultaneous screw correction after posterior spinal fusion. While traditional VATS uses a double lumen tube (DLT) in the lateral decubitus position, DLTs are less ideal for prone surgery. Bronchial blockers (BB), like the EZ-Blocker (Teleflex, Wayne, Pennsylvania), can be used with a more stable armoured single lumen tube (SLT). The EZ-Blocker, a Y-shaped BB, offers stability and sequential lung isolation. Studies show EZ-Blocker performance is comparable to DLTs in lung isolation quality and surgeon satisfaction, though it requires longer placement time and offers limited suctioning. This case demonstrates that an EZ-Blocker with an armoured SLT is a safe, effective airway option for prone VATS.