To the Editor:—
A 21-yr-old woman with stricture esophagus after ingestion of a corrosive 3 yr previously was scheduled to undergo esophagocoloplasty. Anesthesia was induced in a standard manner, and the trachea was intubated with a 7.5-mm-ID cuffed polyvinyl chloride tube. After mobilizing the colon in the abdomen, an incision was made on the left side of the neck to open the esophagus for anastomosis. However, the surgeon had difficulty in identifying the esophagus. Insertion of a nasogastric tube was not successful, possibly because of extensive scarring in that region. At that time, a light wand (Surch-lite, Orotracheal Lighted Intubation Stylet; Aron Medical, St. Petersburg, FL) was introduced into the oral cavity under direct vision using a laryngoscope and was negotiated behind the laryngeal opening. It was gently pushed in the region of the upper end of esophagus, which appeared deformed because of extensive scarring. A glow of light was seen through the cervical incision. When the light wand could not be advanced further, a nick was made by the surgeon at the center of the glow to open up the esophagus. Thereafter, anastomosis was established between the colon and the upper end of the esophagus uneventfully.
The light wand is a malleable bougie-like device with a light source at the distal end that is operated through a switch located at the back of the handle. It is a used for tracheal intubation without performing direct laryngoscopy.
We wish to highlight that the light wand can be helpful in identifying the esophagus in the operative area in the neck. We have used it in five patients who have undergone esophagocoloplasty and pharyngocoloplasty. This device is simple to use, is safe, and is commonly available in most operating rooms. We recommend its use in patients where identification of the esophagus is difficult.
*GB Pant Hospital (University of Delhi), New Delhi, India. email@example.com