Internet Journal of Airway Management


Volume 6 (January 2010 to December 2011)


The D-BLADE: a Significantly Modified Blade for the Storz C-MAC Videolaryngoscopy System



Schirin M. Missaghi, MD1, Klaus Krasser, MD,1 and Ernst Zadrobilek, MD2  


1 Staff Anesthetist and Intensive Care Physician, Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of Vienna, Vienna, Austria.

2Associate Professor of Anesthesia and Intensive Care, Chairman of the Austrian Working Group for Airway Management, Vienna, Austria.


Address correspondence and comments to Schirin M. Missaghi.


Received from the Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of Vienna, Vienna, Austria.


Published: November 6, 2010.



The correct citation of this communiction of new equipment and techniques is:

Missaghi SM,  Krasser K, Zadrobilek E. The D-BLADE: a significantly modified blade for the Storz C-MAC Videolaryngoscopy System. Internet Journal of Airway Management 6, 2010-2011.
Available from URL:
Date accessed: month day, year.


Last updated: January 30, 2011.


The original blades for the C-MAC Videolaryngoscopy System (CMAC; manufactured by Karl Storz Endoscopy, Tuttlingen, Germany) are similar in design to standard Macintosh laryngoscopes. The manufacturer of the CMAC recently launched the D-BLADE Video Laryngoscope Blade (DVL) with a significantly modified blade curvature; D stands for Volker Doerges (anesthetist in Kiel, Germany) as co-inventor of the DVL.


The CMAC blades incorporate a digital camera and a light-emitting diode and are connnected with an ergonomically designed laryngoscope handle. The image on the distal lens is acquired using complementary metal oxide semiconductor technology which guarantees a field of vision extended to 80 grades and contributes to the prevention of fogging. The light supplied is based on light-emitting diode technology. The electronics module (plugged into the receptacle of the laryngoscope handle) is the interface via a power cord/video cable between the CMAC blade and the video unit. The magnified color image is displayed on a high-resolution, thin-film transistor video monitor; the white balance is performed automatically (with the option of manual white balance) and the brightness can be adapted to light or dark surroundings. The video unit is powered by rechargeable lithium-ion batteries (operating for approximately 120 minutes when fully charged). Video sequences and still images can be stored on a secure digital memory card with an USB port for data transfer and futher processing (integrated in the video unit).


Because of ease handling using the familiar Macintosh-laryngoscopy technique with indirect lifting of the epiglottis, portability, and provision of a wide visual view of laryngeal structures, the CMAC may be a suitable alternative device for routine and difficult laryngoscopy and tracheal intubation; unfortunately, there are only two published studies available on the use of the original CMAC blades in patients with apparently normal and simulated difficult airways (1, 2).


Compared to the original CMAC blades, the DVL, currently available only in one size for use in adult patients, is characterized by a pronounced elliptical curvature with the distal end facing distinctly upwards. These features of the DVL may further improve the laryngeal views particularly in patients with difficult conventional laryngoscopy; this suggestion is supported by a recently published case series including patients with routine and difficult tracheal intubation (3).


We requested and received an offer for the CMAC and the DVL from the Austrian division of Karl Storz Endoscopy. Economic considerations are usually provided by this journal but the product manager did not allow us to communicate this information.




  1. Byhahn C, Iber T, Zacharowski K, Weber CF, Ruesseler M, Schalk R, Meininger D. Tracheal intubation using the mobile C-MAC video laryngoscope for patients with a simulated difficult airway. Minerva Anestesiol 76:577-583, 2010.

  2. Cavus E, Kieckhaefer J, Doerges V, Moeller T, Thee C, Wagner K. The C-MAC videolaryngoscope: first experiences with a new device for videolarynoscopy-guided intubation. Anesth Analg 110:473-477, 2010.

  3. Cavus E, Neumann T, Doerges V, Moeller T, Scharf E, Wagner K, Bein B, Serocki G. First clinical evaluation of the C-MAC D-Blade videolaryngoscope during routine and difficult intubation. Anesth Analg 112:382-385, 2011.

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