LARYNGOSCOPE INSERTION SECTION

• US 20100256451A1
• Filed: 08/28/2008
• Published: 10/07/2010
• Est. Priority Date: 08/28/2007
• Status: Abandoned Application

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Aircraft Medical Limited (Medtronic Plc)
• Inventors: Walker, Morgan James, McGrath, Matthew John Ross
• Application Number:
  US12/675,916
• Publication Number:
  US 20100256451A1
• Time in Patent Office: Days
• US Class Current: 600/185
• CPC Class Codes: A61B 1/00066 Proximal part of endoscope body, e.g. handles A61B1/0052 takes precedence
• CPC Class Codes: A61B 1/267 for the respiratory tract, e.g. laryngoscopes, bronchoscopes
• CPC Class Codes: A61M 16/0488 Mouthpieces; Means for guiding, securing or introducing the tubes guiding or introducing with laryngoscopes A61B1/267; holding devices on the body A61M25/02

Abstract

A laryngoscope insertion section comprising a tube guide comprising at least an inferior tube guiding member and a superior tube guiding member, wherein the thickness of the insertion section in a first region is less than the external diameter of the largest diameter endotracheal tube in an operating range of endotracheal tube sizes plus the thickness of the inferior tube guiding member plus the thickness of the superior tube guiding member. Typically, the insertion section comprises an elongate member and the tube guide is lateral of the elongate member. Typically, an endotracheal tube is retained within the tube guide in flexural tension.

Claims

1. An elongate laryngoscope insertion section having a proximal end and a distal end for insertion into a patient'"'"'s oral cavity in use, the insertion section comprising a tube guide for removably retaining an endotracheal tube and guiding a retained endotracheal tube towards a patient'"'"'s larynx, the tube guide comprising a plurality of tube guiding members having tube guiding surfaces which are arranged to contact and thereby guide the inferior or superior surface of a retained endotracheal tube, the plurality of tube guiding members comprising at least an inferior tube guiding member having a tube guiding surface on a superior side thereof for contacting and thereby guiding the inferior surface of a retained endotracheal tube, and a first superior tube guiding member having a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, wherein the insertion section comprises a first region, which is proximal of the tube guiding surface of the first superior tube guiding member, where the thickness of the insertion section is less than the sum of the external diameter of the largest external diameter endotracheal tube in an operating range of endotracheal tube sizes plus the mean thickness of the inferior tube guiding member plus the mean thickness of the first superior tube guiding member.

2. An elongate laryngoscope insertion section according to claim 1, wherein the tube guide is arranged such that a retained endotracheal tube can be removed laterally from the tube guide.

3. An elongate lateral laryngoscope insertion section according to claim 1, wherein the tube guide is arranged such that a retained endotracheal tube can be removed laterally from the tube guide in situ within a patient.

4. An elongate laryngoscope insertion section according to claim 1, wherein the insertion section is arranged such that a retained endotracheal tube remains exposed along an entire lateral side.

5. An elongate laryngoscope insertion section according to claim 1, wherein at least a part of the tube guiding surface of the first superior tube guiding member is opposite at least a part of the tube guiding surface of the inferior tube guiding member.

6. An elongate laryngoscope insertion section according to claim 1, wherein the first region comprises a region of the insertion section which is close to a patient'"'"'s teeth when the insertion section is fully inserted into a patient.

7. An elongate laryngoscope insertion section according to claim 1, wherein the insertion section comprises a curved portion such that the inferior surface of the insertion section is incurvate and the superior surface of the insertion section is excurvate and the first superior tube guiding member is located sufficient distally of the first region to guide a retained tube at an angle of at least 20°

to the angle at which a retained tube is guided at the proximal end of the insertion section.

8. An elongate laryngoscope insertion section according to claim 1, wherein the first region of the insertion section extends along at least 1 cm of the length of the insertion section.

9. An elongate laryngoscope insertion section according to claim 1, wherein the plurality of tube guiding members further comprises a second superior tube guiding member having a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, wherein the second superior tube guiding member is proximal of the first superior tube guiding member and the tube guiding surfaces of the first and second superior tube guiding members are spaced apart.

10. An elongate laryngoscope insertion section according to claim 9, wherein the tube guide is arranged such that the superior surface of a retained endotracheal tube is exposed between the first and second superior tube guiding members.

11. An elongate laryngoscope insertion section according to claim 9, arranged to leave the inferior surface of a retained endotracheal tube exposed opposite the second superior tube guiding member.

12. An elongate laryngoscope insertion section according to claim 9, wherein the distal end of the tube guiding surface of the second superior tube guiding member and the proximal end of the tube guiding surface of the inferior tube guiding member are spaced apart along the length of the insertion section.

13. An elongate laryngoscope section according to claim 12, wherein the component which is parallel to a superior-inferior axis of the displacement between the distal end of the tube guiding surface of the second superior tube guiding member and the proximal end of the tube guiding surface of the inferior tube guiding member is less than the external diameter of the largest external diameter endotracheal tube in an operating range of endotracheal tube sizes.

14. An elongate laryngoscope insertion section according to claim 9, wherein the thickness of the insertion section between the second superior tube guiding member and the first tube guiding member is less than the thickness of the insertion section at one and preferably both of the first and second superior tube guiding members.

15. An elongate laryngoscope insertion section according to claim 9, wherein the tube guiding members are arranged such that endotracheal tubes having a range of external diameters within the operating range of endotracheal tube external diameters will contact the tube guiding surface of either one of or preferably both the proximal and distal superior tube guiding members only at the distal ends of the respective tube guiding member, when a retained endotracheal tube is at rest, retained within the tube guide.

16. An elongate laryngoscope insertion section according to claim 15, wherein endotracheal tubes having a range of external diameters within the operating range of endotracheal tube external diameters only contact the tube guiding surface of the inferior tube guiding member at the proximal end of the tube guiding surface, when a retained endotracheal tube is at rest, retained within the tube guide.

17. An elongate laryngoscope insertion section according to claim 1, wherein the tube guide is arranged such that, for endotracheal tubes of a range of external diameters a retained endotracheal tube will not be retained parallel to the length of the insertion section but have a different radius of curvature than the insertion section along at least a portion of the insertion section.

18. An elongate laryngoscope insertion section according to claim 17, wherein the tube guide is arranged such that, for the largest endotracheal tubes in the operating range of external diameters a retained endotracheal tube will have a greater radius of curvature than the insertion section along at least a portion of the insertion section and the smallest endotracheal tubes in the operating range of external diameters a retained endotracheal tube will have a shorter radius of curvature than the insertion section along at least a portion of the insertion section.

19. An elongate laryngoscope insertion section according to claim 1, wherein the tube guiding surface of the first superior tube guiding member extends inferiorly towards its distal end.

20. An elongate laryngoscope insertion section according to claim 1, wherein the insertion section only includes one or more tube guiding surfaces which extend to contact and thereby guide the inferior surface of a retained endotracheal tube distally of a patient'"'"'s teeth when the insertion section is fully inserted into a patient.

21. An elongate laryngoscope insertion section according to claim 1, wherein the tube guiding surface of the inferior tube guiding member extends proximally of the tube guiding surface of the first superior tube guiding member.

22. An elongate laryngoscope insertion section according to claim 1, comprising an elongate member which extends along the majority of the length of the insertion section, with the tube guide arranged to retain an endotracheal tube laterally of the elongate member.

23. An elongate laryngoscope insertion section according to claim 22, wherein the elongate member comprises imaging apparatus or a bore configured to receive an elongate insertion section supporting member which comprises imaging apparatus and/or illumination apparatus.

24. An elongate laryngoscope insertion section according to claim 22, wherein at least one location where the insertion section comprises a said elongate member with an adjacent tube guide, the thickness of the elongate member is less than the thickness of the adjacent tube guide in use.

25. An elongate laryngoscope insertion section according to claim 22, wherein at least one location where the tube guide comprises a superior tube guiding member, the superior tube guiding member extends further in a superior direction than the elongate member, adjacent to the superior tube guiding member.

26. An elongate laryngoscope insertion section according to claim 22, wherein at least one location where the tube guide comprises an inferior tube guiding member, the inferior tube guiding member extends further in an inferior direction than the elongate member, adjacent to the inferior tube guiding member.

27. An elongate laryngoscope insertion section according to claim 1, wherein one of more of the tube guiding members are discontinuous.

28. An elongate laryngoscope insertion section according to claim 1, wherein the insertion section is rigid, monolithic, disposable and at least partially transparent.

29. An elongate laryngoscope insertion section according to claim 1, wherein the insertion section is removably attachable to a laryngoscope body.

73. A laryngoscope comprising a handle, and an insertion section according to claim 1.

74. A laryngoscope according to claim 73, wherein the insertion section is fixedly attached to the handle.

30. An elongate laryngoscope insertion section having a proximal end and a distal end for insertion into a patient'"'"'s oral cavity in use, the insertion section comprising a tube guide for removably retaining an endotracheal tube and guiding a retained endotracheal tube towards a patient'"'"'s larynx, the tube guide comprising a plurality of tube guiding members having tube guiding surfaces which are arranged to contact and thereby guide the inferior or superior surface of a retained endotracheal tube, the plurality of tube guiding members comprising at least an inferior tube guiding member having a tube guiding surface on a superior side thereof for contacting and thereby guiding the inferior surface of a retained endotracheal tube, and first and second superior tube guiding members each of which has a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, wherein the second superior tube guiding member is proximal of the first superior tube guiding member and the tube guiding surfaces of the first and second superior tube guiding members are spaced apart, wherein the tube guide is arranged to leave exposed the inferior surface of a retained endotracheal tube opposite the tube guiding surface of the second superior tube guiding member.

31. An elongate laryngoscope insertion section according to claim 30, wherein the distal end of the tube guiding surface of the second superior tube guiding member is spaced apart from and proximal of the proximal end of the tube guiding surface of the inferior tube guiding member, such that an endotracheal tube can be introduced into the tube guide between the proximal end of the tube guiding surface of the inferior tube guiding member and the distal end of the tube guiding surface of the second superior tube contacting member at an angle to the length of the insertion section at the proximal end of the tube guiding surface of the inferior tube guiding member.

32. An elongate laryngoscope insertion section according to claim 30, wherein the tube guiding surface of the first superior tube contacting member extends inferiorly towards its distal end and the tube guiding surface of the second superior tube contacting member extends superiorly towards its distal end.

33. An elongate laryngoscope insertion section having a proximal end and a distal end for insertion into a patient'"'"'s oral cavity in use, the insertion section comprising a tube guide for removably retaining an endotracheal tube and guiding a retained endotracheal tube towards a patient'"'"'s larynx, the tube guide comprising a plurality of tube guiding members having tube guiding surfaces which are arranged to contact and thereby guide the inferior or superior surface of a retained endotracheal tube, the plurality of tube guiding members comprising at least an inferior tube guiding member having a tube guiding surface on a superior side thereof for contacting and thereby guiding the inferior surface of a retained endotracheal tube, and a first superior tube guiding member having a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, wherein at least a portion of the tube guiding surface of the inferior tube guiding member is proximal of the tube guiding surface of the first superior tube guiding member.

34. An elongate laryngoscope insertion section according to claim 33, wherein the tube guiding surface of the inferior tube guiding member is entirely proximal of the tube guiding surface of the first superior tube guiding member.

35. An elongate laryngoscope insertion section according to claim 33, wherein the tube guide further comprises a second superior tube guiding member which has a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, wherein the second superior tube guiding member is proximal of the first superior tube guiding member and the tube guiding surfaces of the first and second superior tube guiding members are spaced apart, wherein the tube guiding surface of the second superior tube guiding member is spaced apart from and proximal of the proximal end of the tube guiding surface of the inferior tube guiding member, such that an endotracheal tube can be introduced into the tube guide between the proximal end of the tube guiding surface of the inferior tube guiding member and distal end of the tube guiding surface of the second superior tube contacting member at an angle to the length of the insertion section at the proximal end of the tube guiding surface of the inferior tube guiding member.

36. An elongate laryngoscope insertion section having a proximal end and a distal end for insertion into a patient'"'"'s oral cavity in use, the insertion section comprising a tube guide for removably retaining an endotracheal tube and guiding a retained endotracheal tube towards a patient'"'"'s larynx, the tube guide comprising a plurality of tube guiding members having tube guiding surfaces which are arranged to contact and thereby guide the inferior or superior surface of a retained endotracheal tube, the plurality of tube guiding members comprising at least an inferior tube guiding member having a tube guiding surface on a superior side thereof for contacting and thereby guiding the inferior surface of a retained endotracheal tube, and a first superior tube guiding member at the distal end of the tube guide having a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, wherein the tube guide is arranged so that, for endotracheal tubes of a range of external diameters, a retained endotracheal tube will be continuously curved at least from where a retained endotracheal tube extends through a patient'"'"'s teeth when the insertion section is inserted fully into a patient to the first superior tube guiding member.

37. An elongate laryngoscope insertion section according to claim 36, wherein the tube guide is arranged to retain the endotracheal tube with a substantially constant radius of curvature.

38. An elongate laryngoscope insertion section according to claim 36, wherein the tube guide is arranged to retain the endotracheal tube under flexural tension from the most proximal location where the tube guide contacts the superior surface of a retained endotracheal tube to the most distal location where the tube guide contacts the superior surface of a retained endotracheal tube.

39. An elongate laryngoscope insertion section according to claim 36, wherein the tube guide also contacts the inferior surface of a retained endotracheal tube intermediate the most proximal and most distal locations where the tube guide contacts the superior surface of a retained endotracheal tube, such that a retained endotracheal tube exerts a superior force on the tube guide at the most proximal and most distal locations where the tube guide contacts the superior surface of a retained endotracheal tube and an inferior force at the said location where the tube guide contacts the inferior surface of a retained endotracheal tube.

40. An elongate laryngoscope insertion section according to claim 39 wherein the tube guide opens laterally to facilitate the removal of a retained endotracheal tube in situ within a patient.

41. An elongate laryngoscope insertion section having a proximal end and a distal end for insertion into a patient'"'"'s oral cavity in use, the insertion section comprising a tube guide for removably retaining an endotracheal tube and guiding a retained endotracheal tube towards a patient'"'"'s larynx and an elongate member, wherein the tube guide comprises a plurality of tube guiding members which extend laterally of the elongate member and have tube guiding surfaces which are arranged to contact and thereby guide the inferior or superior surface of a retained endotracheal tube, the plurality of tube guiding members comprising at least an inferior tube guiding member having a tube guiding surface on a superior side thereof for contacting and thereby guiding the inferior surface of a retained endotracheal tube, and a first superior tube guiding member having a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, wherein, at least one location along the length of the insertion section, the thickness of the elongate member is less than the thickness of the adjacent tube guide.

42. An elongate laryngoscope insertion section according to claim 41, wherein the insertion section is configured such that, at the said at least one location, the thickness of the elongate member is less than the thickness of the adjacent tube guide plus the external diameter of a retained endotracheal tube having the largest external diameter in the operating range of endotracheal tube sizes.

43. An elongate laryngoscope insertion section according to claim 41, wherein at least one location where the tube guide comprises a superior tube guiding member, the superior tube guiding member extends further in a superior direction than the elongate member, adjacent to the superior tube guiding member.

44. An elongate laryngoscope insertion section according to claim 41, wherein at least one location where the tube guide comprises an inferior tube guiding member, the inferior tube guiding member extends further in an inferior direction than the elongate member, adjacent to the inferior tube guiding member.

45. An elongate laryngoscope insertion section according to claim 41, wherein, at least one location proximal of the tube guiding surface of the first superior tube guiding member, the insertion section is arranged such that a retained endotracheal tube at the upper end of an operating range of endotracheal tube sizes has both its inferior and superior surfaces left exposed in use.

46. An elongate laryngoscope insertion section according to claim 41, wherein, at least one location proximal of the tube guiding surface of the first superior tube guiding member, the insertion section is arranged such that a retained endotracheal tube at the upper end of an operating range of endotracheal tube sizes extends inferiorly and superiorly of an adjacent section of elongate member.

47. An elongate laryngoscope insertion section according to claim 41, wherein, at least one location proximal of the tube guiding surface of the first superior tube guiding member, the thickness of the insertion section is less than three-quarters of the diameter of the largest external diameter endotracheal tube in an operating range of endotracheal tube sizes.

48. An elongate laryngoscope insertion section having a proximal end and a distal end for insertion into a patient'"'"'s oral cavity in use, the insertion section comprising a tube guide for removably retaining an endotracheal tube and guiding a retained endotracheal tube towards a patient'"'"'s larynx and an elongate member, wherein the tube guide comprises a plurality of tube guiding members which extend laterally of the elongate member having tube guiding surfaces which are arranged to contact and thereby guide the inferior or superior surface of a retained endotracheal tube, the plurality of tube guiding members comprising at least an inferior tube guiding member having a tube guiding surface on a superior side thereof for contacting and thereby guiding the inferior surface of a retained endotracheal tube, and a first superior tube guiding member having a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, wherein either or both (i) the inferior tube guiding member extends further in an inferior direction than the elongate member adjacent to the inferior tube guiding member or (ii) the superior tube guiding member extends further in a superior direction than the elongate member adjacent to the superior tube guiding member.

52. An elongate laryngoscope insertion section according to claim 48, wherein the tube guide is arranged such that a retained endotracheal tube can be removed laterally from the tube guide.

53. An elongate laryngoscope insertion section according to claim 48, wherein the insertion section is arranged such that a retained endotracheal tube remains exposed along an entire lateral side.

49. An elongate laryngoscope insertion section having a proximal end and a distal end for insertion into a patient'"'"'s oral cavity in use, the insertion section comprising a tube guide for removably retaining an endotracheal tube and guiding a retained endotracheal tube towards a patient'"'"'s larynx, wherein the tube guide is adapted to retain endotracheal tubes with a range of external diameters within an operating range of endotracheal tube external diameters, under flexural tension.

50. An elongate laryngoscope insertion section according to claim 49, wherein the tube guide is arranged to retain an endotracheal tube under flexural tension from the most proximal location where the tube guide contacts the superior surface of a retained endotracheal tube to the most distal location where the tube guide contacts the superior surface of a retained endotracheal tube.

51. An elongate laryngoscope insertion section according to claim 50 wherein the tube guide also contacts the inferior surface of a retained endotracheal tube intermediate the most proximal and most distal locations where the tube guide contacts the superior surface of a retained endotracheal tube, such that a retained endotracheal tube exerts a superior force on the tube guide at the most proximal and most distal locations where the tube guide contacts the superior surface of a retained endotracheal tube and an inferior force at the said location where the tube guide contacts the inferior surface of a retained endotracheal tube.

54. An elongate laryngoscope insertion section according to claim 49, wherein the tube guide comprises a plurality of tube guiding members having tube guiding surfaces which are arranged to contact and thereby guide the inferior or superior surface of a retained endotracheal tube, the plurality of tube guiding members comprising at least an inferior tube guiding member having a tube guiding surface on a superior side thereof for contacting and thereby guiding the inferior surface of a retained endotracheal tube, a first superior tube guiding member having a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, and a second superior tube guiding member located proximally of the first superior tube guiding member and having a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, wherein the tube guiding surfaces of the first and second superior tube guiding members are spaced apart, with at least a portion of the tube guiding surface of the inferior tube guiding member being proximal of the proximal end of the tube guiding surface of the first superior tube guiding member and distal of the distal end of the tube guiding surface of the second superior tube guiding member, wherein the tube guiding members are arranged to retain endotracheal tubes with a range of external diameters within an operating range of endotracheal tube external diameters, under flexural tension such that a retained endotracheal tube exerts a force in a superior direction on the first and second superior tube guiding members applying a force in an inferior direction and a force in an inferior direction on the inferior tube guiding member.

55. An elongate laryngoscope insertion section according to claim 54, wherein the tube guiding members are arranged such that, for endotracheal tubes having a range of external diameters within the operating range of endotracheal tube external diameters, a retained endotracheal tube will contact the tube guiding surface of either one of or preferably both the proximal and distal superior tube guiding members only at the distal ends of the respective tube guiding member, when a retained endotracheal tube is at rest, retained within the tube guide.

56. An elongate laryngoscope insertion section according to claim 54, wherein endotracheal tubes having a range of external diameters within the operating range of endotracheal tube external diameters will only contact the tube guiding surface of the inferior tube guiding member at the proximal end of the tube guiding surface, when a retained endotracheal tube is at rest, retained within the tube guide.

57. An elongate laryngoscope insertion section according to claim 49, wherein the tube guide is arranged to that a retained endotracheal tube can be removed laterally from the tube guide.

58. An elongate laryngoscope insertion section according to claim 49, wherein the insertion section comprises an elongate member and the tube guiding members extend laterally from the elongate member.

59. An elongate laryngoscope insertion section according to claim 49, wherein the range of external diameters is the entire operating range of endotracheal tube external diameters.

60. An elongate laryngoscope insertion section having a proximal end and a distal end for insertion into a patient'"'"'s oral cavity in use, the insertion section comprising a tube guide for removably retaining an endotracheal tube and guiding a retained endotracheal tube towards a patient'"'"'s larynx and an elongate member, wherein the tube guide comprises a plurality of tube guiding members which extend laterally of the elongate member and have tube guiding surfaces which are arranged to contact and thereby guide the inferior or superior surface of a retained endotracheal tube, the plurality of tube guiding members comprising at least an inferior tube guiding member having a tube guiding surface on a superior side thereof for contacting and thereby guiding the inferior surface of a retained endotracheal tube, and a first superior tube guiding member having a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, wherein there is at least one location, proximal of the first superior tube guiding member, where an endotracheal tube is retained in use laterally of the elongate member with the inferior and superior sides of the endotracheal tube being left exposed.

61. An elongate laryngoscope insertion section according to claim 60, wherein no tube guiding member is provided at the said location.

62. An elongate laryngoscope insertion section according to claim 60, wherein the said location is intermediate the first and second superior tube guiding members.

63. An elongate laryngoscope insertion section having a proximal end and a distal end for insertion into a patient'"'"'s oral cavity in use, the insertion section comprising a tube guide for removably retaining an endotracheal tube and guiding a retained endotracheal tube towards a patient'"'"'s larynx, wherein the insertion section and tube guide are arranged to leave the inferior or superior surface of a retained endotracheal tube exposed along at least 25% of the length of the insertion section between the most proximal location where the insertion section contacts a retained endotracheal tube and the most distal location where the insertion section contacts a retained endotracheal tube.

64. An elongate laryngoscope insertion section according to claim 63, wherein the inferior surface of a retained endotracheal tube is left exposed along at least 25% of the length of the insertion section between the most proximal location where the insertion section contacts a retained endotracheal tube and the most distal location where the insertion section contacts a retained endotracheal tube.

65. An elongate laryngoscope insertion section according to claim 63, wherein the inferior surface of a retained endotracheal tube is left exposed along at least 50% of the length of the insertion section between the most proximal location where the insertion section contacts a retained endotracheal tube and the most distal location where the insertion section contacts a retained endotracheal tube.

66. An elongate laryngoscope insertion section according to claim 63, wherein the superior surface of a retained endotracheal tube is left exposed along at least 25% of the length of the insertion section between the most proximal location where the insertion section contacts a retained endotracheal tube and the most distal location where the insertion section contacts a retained endotracheal tube.

67. An elongate laryngoscope insertion section according to claim 63, wherein the superior surface of a retained endotracheal tube is left exposed along at least 50% of the length of the insertion section between the most proximal location where the insertion section contacts a retained endotracheal tube and the most distal location where the insertion section contacts a retained endotracheal tube.

68. An elongate insertion section according to claim 63, wherein both the inferior and superior surface of a retained endotracheal tube are left exposed along a continuous region of at least 5% of the length of the insertion section between the most proximal location where the insertion section contacts a retained endotracheal tube and the most distal location where the insertion section contacts a retained endotracheal tube.

69. An elongate insertion section according to claim 68, wherein the continuous region is located close to the teeth of a patient of typical dimensions when the insertion section is inserted fully into a patient in use.

70. An elongate insertion section according to claim 63, wherein the tube guide is arranged to enable a retained endotracheal tube to be removed laterally from the tube guide and a retained endotracheal tube is retained with its lateral side at least partially exposed along the entire length of the insertion section.

71. An elongate insertion section according to claim 63, wherein the insertion section comprises an elongate member and the tube guide comprises a plurality of tube guiding members which extend laterally of the elongate member and have tube guiding surfaces which are arranged to contact and thereby guide the inferior or superior surface of a retained endotracheal tube, the plurality of tube guiding members comprising at least a first superior tube guiding member having a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube and a second superior tube guiding member having a tube guiding surface on an inferior side thereof for contacting and thereby guiding the superior surface of a retained endotracheal tube, wherein the second superior tube guiding member is located proximally of the first superior tube guiding member and the tube guiding surfaces of the first and second superior tube guiding members are spaced apart, wherein the tube guiding surface of the second superior tube guiding member is the most proximal location where the insertion section contacts a retained endotracheal tube.

72. An elongate insertion section according to claim 71, wherein the tube guiding surface of the first superior tube guiding member is the most distal location where the insertion section contacts the superior side of a retained endotracheal tube and the tube guiding surface of the first superior tube guiding member is the most distal location where the insertion section contacts a retained endotracheal tube.