Why do it

After successful fiberoptic intubation via the laryngeal mask you will in most cases remove the laryngeal mask to allow access for surgery. We demonstrate two techniques how you can pull out the laryngeal mask leaving the endotracheal tube in place

How to do it
Stick two identical endotracheal tubes together and thread them on the fiberscope. After the distal end of the tube is pushed into the trachea, fix the proximal end and pull out the laryngeal mask. The proximal tube will stabilize the distal tube and prevent it from dislodging.

An alternative technique uses a thin and long forceps as used by ENT-surgeons or endoscopic surgeons. Fix the proximal end of the tube with the forceps, push the tube slightly deeper into the trachea and pull the laryngeal mask upon the forceps. The forceps will stabilize the tube and prevent it from dislodging.

How do it right. The fine points
Whatever technique you use always check first if all parts of your equipment will fit and move freely and always use a lubricant such as silicone spray to facilitate movement.