Ventilation, as well as intubation of a morbidly obese patient, is challenging and require special preparations and skilful hands, in this study laryngeal mask airway insertion is used as a bridge for intubation to facilitate ventilation as give enough time to anaesthetics and muscle relaxants to work on.

The ordinary pathway of intubating a morbidly obese patient for sleeve gastrectomy is bordered by the risk of difficult ventilation and intubation with the subsequent events of hypoxia and hypoventilation. When the patient is easy ventilated, it gives some sort of confidence and pleasure for the anaesthetist that the way of intubation will not be so hard.

One problem here is the difficulty of ventilating a morbidly obese patient, in this study the investigators used laryngeal mask airway as a bridge before inserting the endotracheal tube

Inclusion Criteria:

• Morbid obese patient BMI>40
• ASA I, II, III
• Elective sleeve gastrectomy

Exclusion Criteria:

• Oral cavity infection or pathological abnormalities
• Suspected or known abnormalities in supraglottic anatomy
• Patients planned for awake fiberoptic intubation