Clinical Evaluation of a Non-inflatable Visual Laryngeal Mask Airway: A Prospective Service Assessment in Elective and Difficult Airway Management

Background: The non-inflatable visual laryngeal mask airway (V-LMA, Tuoren Medical) integrates a high-definition optical channel with an anatomically pre-shaped, non-inflatable cuff, enabling real-time visualization and potentially reducing airway trauma. This prospective service assessment aimed to provide preliminary clinical data on the performance of the V-LMA in elective anesthesia and in predicted difficult airway management. Methods: Thirty-eight adult patients were included, of whom eight had predicted difficult airways based on an El-Ganzouri Risk Index score >4. Primary outcomes included time to ventilation, quality of visualization, and seal performance. Secondary outcomes included gastric insufflation, need for repositioning, mucosal trauma, and postoperative symptoms. Results: Successful device placement was achieved in all patients. The mean time to effective ventilation was 28 ± 4 seconds. Glottic visualization was consistently excellent in all cases. No gastric insufflation, postoperative mucosal injury, or patient-reported discomfort was observed. Device performance remained reliable even in patients with predicted difficult airways. Conclusion: The V-LMA enables rapid, atraumatic, and visually guided airway management, demonstrating excellent performance even in challenging airway conditions. It may serve as a useful first-line supraglottic airway device (SAD) when maintenance of oxygenation is the primary priority.