Figure 49-35 Airway management and surgical procedure for resection of a high tracheal lesion. A, Initial intubation above the lesion. B, Second endotracheal intubation distal to the lesion after the trachea has been opened. C, Placement of sutures for the posterior anastomosis. D, The second endotracheal tube has been removed, and the original endotracheal tube has been advanced distal to the anterior anastomosis. (Modified from Geffin B, Bland J, Grillo HC: Anesthetic management of tracheal resection and reconstruction. Anesth Analg 48:884, 1969.)