The Portable AirWay Scope Video Laryngoscope
Ernst Zadrobilek, MD1
of Anesthesia and Intensive Care, Chairman of the Austrian Working
Group for Airway Management and Director of the Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of
Address correspondence and comments to Ernst
Received from the
Department of Anesthesia
and Intensive Care, Empress Elisabeth Hospital
of the City of Vienna, Vienna, Austria.
Published: June 20, 2007.
The correct citation of this
communiction of new equipment and techniques is:
Zadrobilek E. The portable AirWay Scope video laryngoscope. Internet Journal of Airway Management
Available from URL:
Date accessed: month day, year.
updated: February 12, 2008.
Koyama and co-workers developed a new portable video laryngoscope, the AirWay Scope (AWS),
in cooperation with the Pentax
Corporation (Tokyo, Japan) for use with a dedicated (anatomically
shaped) disposable laryngoscope
blade (DLB). The AWS became commercially available in Japan
during July 2006, and in October 2006,
they reported the first successful clinical
applications of the AWS in 10 consecutive patients requiring orotracheal
intubation for neurosurgical procedures (3).
and co-worker (1) evaluated the AWS for orotracheal
inubation (performed by novice users of this device) in patients
with apparently normal airway anatomy. Tracheal intubation was
successful in 98 of 100 patients (in 96 patients on the first
attempt and in 2 patients on the second attempt, respectively, despite some
problems with fogging of the camera system); in one patient,
laryngoscopy with the AWS was abondened because of loose teeths,
and in a further one, tracheal intubation failed (after a maximum
of two attempts) because the tracheal tube (TT) kept
impacting on the arytenoids. Based
on these results, the AWS may be a suitable alternative device for routine
and difficult laryngoscopy and orotracheal intubation (because
of ease handling and portability and provision of a wide visual view
of laryngeal structures without requiring alignment of oral,
pharyngeal, and laryngeal axes); however, further studies are
required to substantiate these suggestions.
Enomoto and co-workers (2) recently published their experiences
with the AWS in patients with normal airways but with manual
cervical spine immobilization requiring orotracheal intubation for
elective surgical procedures; AWS laryngeal views of the entire
laryngeal were obtained in all 203 investigated patients,
whereas Macintosh laryngeal views of only the epiglottis or the
soft palate were encountered in 11 percent (22/203 patients).
The study design provided only one tracheal intubation attempt
with the randomized laryngoscope; AWS-assisted tracheal
intubation was successful in 100 percent (99/99 patients) and
failures with conventional tracheal intubation were observed in
89 percent 93/104 patients).
The AWS is composed of the main body with a miniaturized video screen
(a movable liquid crystal display color monitor), the
camera unit (flexible, with a charge-coupled device sensor and a light-emitting diode), and the DLB. Light is supplied by
alkaline batteries incorporated in the main body of the AWS,
activated by pressing the button on the right side of the AWS
The DLB is currently available only in a single size for adults (with a
maximum thickness of 18 mm) and supplied in a
sterile packaging, ready for use. With the
provision of the DLB, there is no need to wait for hygienic
reprocessing of the device between uses, ideal for fast-paced tracheal
intubation settings. The DLB incorporates a tube-guide channel on the right
side to guide the TT and may be loaded with TTs up to 8.5 mm
inner diameter; in addition, there is a further channel for passage of a
suction catheter, when required.
intubation, the selected preformed and curved TT (tested for cuff leakage and lubricated with a
water-soluble lubricant) is placed into the tube-guide channel of the DLB.
The AWS system (with the attached camera unit and the DLB) is inserted in the midline into the oral cavity.
The DLB should be placed beneath
the epiglottis (Miller-laryngoscopy technique) to obtain a view of the laryngeal aperture
When the green
target symbol on the monitor is aligned with the
laryngeal aperture, the TT may be advanced without difficulties
and problems into a
Visualization of the tracheal intubation process is maintained
throughout the procedure. The AWS body incorporates a video output, enabling
visualization of the procedure on a NTSC-compatible external medical monitor.
Asai T, Enomoto Y, Shimuizu K, Shingu K, Okuda Y. The
Pentax-AWS video-laryngoscope: the first experience in one
Anesth Analg 106:257-259, 2008.
Enomoto Y, Asai T, Arai T, Kamishima K, Okuda Y. Pentax-AWS,
a new videolaryngoscope, is more effective than the
Macintosh laryngoscope for tracheal intubation in patients
with restricted neck movements: A randomized comparative
Br J Anaesth
Koyama J, Aoyama T, Kusano Y, Seguchi T, Kawagishi K, Iwashita T,
Okamoto K, Okudera H, Takasuna H, Hongo K. Description and
first clinical application of AirWay Scope for tracheal
J Neurosurg Anesthesiol