Case report: Use of two balloon-tipped catheters during thoracoscopic repair of a type C tracheoesophageal fistula in a neonate.

PURPOSE: To describe a novel airway management technique for thoracoscopic repair of a type C tracheoesophageal fistula (TEF) in a neonate. CLINICAL FEATURES: A full-term neonate with a type C TEF presented for thoracoscopic repair. The fistula was at the level of the carina, making its isolation from positive pressure ventilation using traditional techniques difficult. In addition, non-ventilation of the right lung was required. The use of two Fogarty type balloon-tipped embolectomy catheters placed alongside the endotracheal tube successfully achieved the goal of blocking ventilation of the fistula and the right lung. The use of fibreoptic bronchoscopy greatly facilitated placement of the blockers. The patient made an uneventful recovery. CONCLUSION: Placing two balloon-tipped blockers, one in the TEF and the other in the right mainstem bronchus, is a viable technique for thoracoscopic fistula repair when the fistula is at or very close to the level of the carina.

Facial skin injuries caused by adhesive tapes in a patient receiving cosmetic skin exfoliants.

A 39-yr-old woman underwent general anesthesia for laparoscopic sterilization. We used adhesive tapes to close her eyelids and to secure the tracheal tube. Removal of the tapes caused patchy areas of skin loss. We later discovered that the patient had fragile facial skin from cosmetics containing skin exfoliants. We recommend taking a detailed drug history before anesthesia and avoiding adhesive tapes to the patient's face under general anesthesia.