Figure 49-37 Airway management and surgical procedure for resection of a carinal lesion. A, Initial intubation above the lesion. B, Left endobronchial intubation distal to the lesion after the left main stem bronchus has been severed. C, The trachea is anastomosed to the right main stem bronchus. D, The left endobronchial tube has been removed to allow for anastomosis between the trachea and left main stem bronchus. Ventilation is accomplished through the original endotracheal tube. (Modified from Geffin B, Bland J, Grillo HC: Anesthetic management of tracheal resection and reconstruction. Anesth Analg 48:884, 1969.)