Robertshaw Tube

WLMD ID: apok
Anesthesiologists may insert a breathing tube into the patient's airway to deliver inhalation anesthesia. Located below the larynx (voice box), the trachea (windpipe) divides into the right and left bronchi, conducting air in and out of the lungs. The bronchi are of unequal diameter and length. Some of the tubes used by anesthesiologists are double-lumen tubes designed specifically to enter the right or the left bronchus. These tubes are primarily used during lung surgery, in order to isolate one lung.

British anesthesiologist, researcher and inventor Frank L. Robertshaw, M.D., FFARCS (1918-1991), was one of the team that tested the first modern non-explosive anesthetic, halothane. He introduced his double-lumen endobronchial tube in 1962. Its two hollow channels have a wide diameter, to reduce air-flow resistance. The tube has a cuff near the distal tip, which can be inflated using either of the two small side tubes. Made in left-sided and right-sided models, the Robertshaw tube continues in use today. The example shown here was made for use in the right bronchus, and was produced in 2009 by the original manufacturer.

Catalog Record: Robertshaw Tube Robertshaw Tube

Access Key: apok

Accession No.: 2011-05-18-1

Title: [Robertshaw double-lumen endobronchial tube] / Phoenix Medical Ltd.

Author: Robertshaw, Frank Leonard, b. 1918.

Corporate Author: Phoenix Medical, Ltd.

Title variation: Alt Title
Title: Right-sided Robertshaw tube.

Publisher: Preston, Lancashire, United Kingdom : Phoenix Medical, Ltd., 2009.

Physical Description: 1 endobronchial tube : rubber, plastics ; 3 x 52 x 32.5 cm.

Subject: Anesthesia, Inhalation – instrumentation.
Subject: Anesthesia, Endotracheal – equipment & supplies.

Note Type: General
Notes: The first year in the date range is the year that the manufacturer began to produce single-use Robertshaw tubes. The second year in the date range is the year that the company changed its name to P3 Medical, Ltd.

Interpretation of the dimensions will vary depending on angle at which it is held and the deployment of the inflation tubes. It is described with the device lying on a flat surface, and with the inflation tubes fully extended.

Note Type: With
Notes: A transparent plastic connector is inserted in the blue tube on the user’s right.

Note Type: Citation
Notes: Bjork VO, Carlens E, Friberg O. Endobronchial anesthesia. Anesthesiology. January, 1953;14(1):60-72.

Note Type: Citation
Notes: Dorsch JA, Dorsch SE. Understanding Anesthesia Equipment, 4th ed. Baltimore: Williams & Wilkins, 1999.

Note Type: Citation
Notes: Down Brothers, Ltd. A Catalogue of Surgical Instruments and Appliances with Appendix, Including a Large Number of Original Designs Manufactured and Sold by Down Bros., Ltd. London: Down Brothers, Ltd., 1929:1359c.

Note Type: Citation
Notes: Franklin CB. Robertshaw endobronchial tubes: variation in specification or production. Anaesthesia. May, 1973;28(3):343.

Note Type: Citation
Notes: Frenckner P, Bjorkman S. Bronchospirometry and its clinical application, with a short account of bronchial catheterization. J Laryngology & Otology. April, 1937;52(4):233-248.

Note Type: Citation
Notes: Magill IW. The provision for expiration in endotracheal insufflation anaesthesia. Lancet. July 14, 1923;202(5211):68-69.

Note Type: Citation
Notes: P3 Medical website. http://www.p3medical.com/. Accessed March 27, 2017.

Note Type: Citation
Notes: Roberts JT. Clinical Management of the Airway. Philadelphia: Saunders, 1994:.244-247.

Note Type: Citation
Notes: Robertshaw FL. Low resistance double-lumen endobronchial tubes. Brit J Anaes. July, 1962(7):576-579.

Note Type: Citation
Notes: Robertshaw FL. A reply. Anaesthesia. May, 1973;28(3):344-345.

Note Type: Citation
Notes: Robertshaw Tube Subject File. Located at: Wood Library-Museum of Anesthesiology, Schaumburg, Illinois.

Note Type: Citation
Notes: Sosis MB, ed. Anesthesia Equipment Manual. Philadelphia: Lippincott, 1997:232-234.

Note Type: Citation
Notes: Waters RM, Rovenstine EA, Guedel AE. Endotracheal anesthesia and its historical development. Anesth Analg. September-October, 1933;12(5):196-203.

Note Type: Citation
Notes: Zeitlin GL, Short H, Ryder GH. An assessment of the Robertshaw double-lumen tube. Brit J Anaeth. 1965;37(11):858-860.

Note Type: Physical Description
Notes: One double-lumen endobronchial tube, made of three colors of rubber; The main shaft measures approximately 39 centimeters long, and is flesh-colored or pink; At the distal end, the shaft thickens and widens, and divides into two short tubes; The short tube on the user’s right is made of blue rubber, and that on the user’s left is made of red rubber; When the device is held in position for use, these short tubes stand roughly upright and are canted toward the user; In this position, the height of the tube is approximately 26 centimeters;

Approximately 1 centimeter below the divided portion of the shaft, two slender inflation tubes enter the shaft; That entering the upper side of the shaft is made of blue rubber, and that entering the lower side of the shaft is made of red rubber; Each of these tubes is approximately 25 centimeters long, and each has an inflation, or pilot, balloon approximately four centimeters below the distal tip; Each of these side tubes can be closed by inserting the attached cap; When the object is held in position for use, the blue inflation tube dangles over the top of the shaft and the red one dangles below the shaft;

Measuring from the top of the short tubes toward the proximal end, that portion of the shaft between the 24th and the 31st centimeter is covered in a red rubber sheath; That portion of the shaft between the 33rd and the 38th centimeter is covered in a blue rubber sheath; This blue portion holds a slot for ventilation of the upper lobe of the right lung; The lumen on the opposite side of the shaft is truncated approximately 1 centimeter below the red rubber sheath; When in use, the truncated tube (associated with the blue rubber parts) ends in the trachea, while the longer tube (associated with the red rubber parts) ends in one of the bronchi (Sosis, p. 235);

The right side of the shaft is marked: “2009-04-30 [new line] Medium Right [new line] PHOENIX [new line] Robertshaw Double Lumen Made in U.K. [new line] SINGLE USE”; Directly opposite this, the left side of the shaft is marked: “CE 0120”.

Note Type: Reproduction
Notes: Photographed by Mr. Steve Donisch, November 15, 2016.

Note Type: Acquisition
Notes: Gift of Hanns Hasche-Klunder, M.D.

Note Type: Historical
Notes: Anesthesiologists may insert a breathing tube into the patient’s airway to deliver inhalation anesthesia. Located below the trachea (windpipe), the bronchus divides into the right and left bronchi, conducting air in and out of the lungs. These bronchi are of unequal diameter and length. Some of the tubes used by anesthesiologists are designed specifically to enter the right or the left bronchus. These tubes are primarily used during lung surgery to isolate one lung.

In 1854, Green and Reese became the first physicians to intubate the human bronchi to administer medication (Waters, p. 196). In 1923, the influential British anesthesiologist Sir Ivan Magill (1888-1986) introduced a double tracheal tube. This consisted of an ordinary endotracheal tube, with a second tube attached at its midpoint. The purpose of the second tube was to shunt the patient’s exhaled breath away. Twelve years later, the first double-lumen bronchoscope was introduced by Swedish physician, Paul Frenckner M.D. (d. 1967.) Unlike Magill’s instrument, a double-lumen tube is a single tube containing two hollow channels. In 1949, Swedish physician Eric Carlens, M.D. introduced what is considered the first practical double-lumen endobronchial tube for anesthesia.

British anesthesiologist, researcher and inventor Frank L. Robertshaw, M.D., FFACRS (1918-1991), was one of the team that tested the first modern non-explosive anesthetic, halothane. He introduced his own double-lumen endobronchial tube in 1962. It’s two lumens have a wider diameter than those of the Carlens tube, to reduce air-flow resistance. Each lumen is entered by a smaller tube with pilot balloon, to inflate the bronchial cuff near the proximal end.

The cataloged object is a single-use tube, size medium, made for use in the right bronchus. The manufacturer was founded as Leyland Medical, and was the original maker of Robertshaw tubes. In 1991, the company changed its name to Phoenix Medical, Ltd. In 1995, Phoenix modified the product for single use only. Phoenix became P3 Medical, Ltd. in 2005. As of this writing (March, 2017) the company continues to make the Robertshaw tube in left-sided and right-sided models, in four sizes.

Note Type: Publication
Notes: Carlens E. New flexible double-lumen catheter for bronchoscopy. J Thoracic Surgery. October, 1949; 18: 742-746.

Note Type: Publication
Notes: Frenckner P. Bronchial and tracheal catheterization. Acta Oto-Laryngol. 1934; Supplement 20.

Note Type: Publication
Notes: Paul Frenckner, M.D. (Obituary). Acta Oto Rhino Laryngol. August, 1967;76(3):719.

Note Type: Exhibition
Notes: Selected for the WLM website.