In reply. Safe and effective positioning of a left-sided double-lumen tube.

To the Editor, As discussed in our paper, positioning the VivaSight DLT 34 sec faster than positioning a conventional doublelumen tube is of marginal clinical importance. Then again, faster insertion is consistent with the fact that the tube is easy to use. Furthermore, the ability to obtain immediate assurance of at least an approximately correct position with the VivaSight camera likely facilitates initial insertion and awareness that the tube was not dislodged when changing the patient’s position. Clinicians should nonetheless use flexible bronchoscopy to confirm the proper position of any double-lumen tube, and we recommended the procedure in our paper even for VivaSight tubes. The most important clinical benefit of the VivaSight system appears to be continuous visualization of tube position during surgery, thus facilitating early detection of any intraoperative malpositioning.