Transillumination of H-type tracheoesophageal fistula using flexible miniature bronchoscopy: an innovative technique for operative localization.

Precise localization of the fistula is the most important step in the operative strategy for dealing with H-type tracheoesophageal fistula. Bronchoscopic cannulation of the fistula with a Fogarty or ureteric catheter has been recommended to aid ready identification, but it is not always successful. We report an innovative technique that permitted localization of H-type fistula intraoperatively. A flexible pediatric 2.2-mm bronchoscope (Olympus BF Type N20) was steered through a standard endotracheal tube, and the fistula tract was illuminated, making its identification and subsequent repair straightforward. We have successfully deployed this approach in 3 newborns. We recommend the technique to localize H-type fistula.