A laryngoscope is a medical instrument designed to examine the larynx and upper respiratory tract. It consists of a handle and a blade (straight or curved) with a built-in light guide that allows you to lift the epiglottis and provide an overview of the glottis. A laryngoscope is indispensable in the procedure of tracheal intubation during anesthesia, resuscitation or emergency care. The main task of the instrument is to provide a clear view of the glottis for the safe insertion of an endotracheal tube.
Modern laryngoscopes are available in two main design options with the ability to choose from different types of blades and handles - depending on the anatomical features of the patient and the conditions of clinical use:
• Classic (optical) - with direct examination through the oral cavity.
• Video laryngoscopes - modern models with an integrated miniature camera and display, allowing indirect visualization of the larynx.
Laryngoscope blades come in different shapes and sizes, allowing the instrument to be adapted to the patient's anatomical features. The most common are curved (Macintosh) and straight (Miller) blades:
1. Straight Blade (Miller Type)
Straight blades are commonly used in neonates, children, or patients with difficult airways. The blade is inserted under the epiglottis, which is lifted by the forward movement of the laryngoscope. This provides a clear view of the vocal cords, trachea, and arytenoid cartilages.
Suggested sizes for Miller type blades:
• 00, 0 – for neonates
• 1 – for infants
• 2 – for children
• 3, 4 – for adults
2. Curved Blade (Macintosh Type)
The Macintosh is the most common blade for adults. Its tip is placed in the vallecula (anatomical depression between the base of the tongue and the epiglottis), where the glottis opens due to indirect action on the epiglottis.
Recommended sizes for Macintosh blades:
• 1 – for infants
• 2 – for children
• 3 – for adolescents and women
• 4 – for men and patients with large body mass
3. Universal pediatric blade (WIS/Paed type)
This type of blade is intuitive for users of both the Macintosh and Miller techniques and may be marked WIS or like the German company HEINE Optotechnik Classic+ Paed line. Paed type blade: a universal blade that combines the functionality of straight and curved blades and provides flexibility when intubating infant patients. The Classic+ Paed blade is suitable for both techniques - with blade placement both under the epiglottis and in the epiglottic vallecula.
Available sizes:
• Paed 0 - length 65 mm
• Paed 1 - length 78 mm
Handles act as a power source for lighting and a point of attachment for the blade. Depending on the design, lighting technology and operating conditions, they can be:
1. Reusable - designed for sterilization and repeated use. Equipped with replaceable batteries or rechargeable elements. For example:
• HEINE EasyClean LED - handles that can be sterilized without removing the lighting module. They are completely waterproof, compatible with autoclaves, as well as with low-temperature sterilization systems (STERRAD, STERIS).
• HEINE Standard F.O. - classic fiber-optic handles with the ability to use easily replaceable batteries or accumulators.
2. With a disposable shell - relevant in conditions where access to sterilization equipment is limited. After use, the shell is disposed of, ensuring quick preparation of the instrument for reuse without additional processing.
3. With integrated LED illumination – provides stable and bright light without the need to change lamps or fibers. HEINE LEDHQ technology ensures accurate color rendering, which is critical during intubation.
To adapt to various clinical scenarios, the handles are available in three standard sizes:
1. SHORT – shortened handles, convenient for intubating newborns or in limited space conditions (e.g. in neonatology or emergency medicine). They have compact dimensions and are lightweight.
2. SLIM – a thin body provides a better grip, especially convenient for users with a small hand or in conditions where maneuverability is important.
3. STANDARD – a classic full-size option for universal use in anesthesiology and resuscitation. The most autonomous option
Video Laryngoscopes and Blade Types
Video laryngoscopes integrate a miniature camera into the blade or handle, providing a clear image of the larynx on a built-in or external display. They are especially useful in cases of difficult intubation, limited visibility, and in the educational process.
Such systems can work:
• With disposable blades made of medical polymers that provide optimal rigidity and transparency, meet hygienic standards and reduce the risk of cross-infection.
• With reusable blades, which can be made of fiberglass, metal or high-quality composites. Some manufacturers use heat-resistant glass to ensure a long service life and compatibility with sterilization.
HEINE offers a modern solution - the visionPRO video laryngoscope. The uniqueness of this video laryngoscope lies in the presence of a transflective HEINE allBRIGHT display, adapting even to the brightest ambient light and intelligent image processing with realistic color rendition with HEINE LEDHQ technology. It is designed for use with disposable Macintosh blades of different sizes:
• HEINE visionPRO Macintosh disposable blades (sizes: Mac 2, Mac 3, Mac 4)
The blades have an intelligent design and the HEINE FixLock fastening system, which meets international safety standards.
• HEINE visionPRO HyMac disposable blades (sizes: HyMac 3)
Created for clinical situations where an increased angle of view of the airway is required. The blade has a reinforced curvature, which provides better visualization with complex anatomy.
HEINE Optotechnik - the standard of quality in the production of laryngoscopes
HEINE Optotechnik is one of the pioneers in the development of laryngoscopes and has been setting standards in the field of anesthesiology and resuscitation for over 75 years. High requirements for materials, German precision engineering and full control over production ensure the reliability and durability of the products.
HEINE quality is evidenced by a long warranty period:
• 10 years on HEINE Classic+ laryngoscope blades
• 5 years on complete sets (handle + blade) in the classic version
• 2 years on the HEINE VisionPRO video laryngoscope
Modern development of laryngoscopes allows you to choose the optimal instrument depending on the age, anatomy of the patient, the level of complexity of intubation and hygiene requirements. Classic reusable laryngoscope sets remain in demand in many clinics, but video laryngoscopes are becoming increasingly popular due to their functionality, safety and high level of visualization.
