Pediatric laser bronchoscopy.

Endoscopic laser surgery can be performed in the airway safely and effectively when a team approach is used. Our team of anesthesia and surgical personnel prefers to treat lesions involving the supraglottic, glottic, or immediately subglottic trachea with a CO2 laser through the laryngoscope, using Venturi ventilation and intravenous sedation and pharmacological paralysis. For distal airway lesions, as far as the mainstem bronchi, our preference is to use manual positive pressure ventilation through a rigid bronchoscope with a flexible KTP or argon fiberoptic laser. Oxygen concentrations should be kept below 50% if possible and one should avoid material that can ignite. For lesions distal to the mainstem bronchi, we prefer to use a flexible bronchoscope through a standard endotracheal tube.