Abstract:
The invention relates to an optical light laryngoscope with a built-in fluid extraction device, of the type comprising two independent conduits. One of the aforementioned conduits is equipped with optical means for viewing the inside of the larynx while the other conduit is used for introducing the endotracheal tube into the larynx. The inventive laryngoscope also comprises a built-in fluid extraction device which is used to withdraw fluids from the mouth in order to optimize the view when the endotracheal tube is being inserted into the patient in a convenient, safe and hygienic manner.

Description:
OBJECT OF THE INVENTION  
       [0001]     The optical light laryngoscope with a built-in fluid extraction device object of the present invention consists of an optical light laryngoscope of the type made up of two independent conduits, one provided with optical means for visualizing the interior of the larynx and the other one for introducing the endotracheal tube in the larynx, in addition to a built-in fluid extraction device in the laryngoscope, the intention of which is to withdraw fluids existing in the mouth in order to achieve optimal vision during the introduction of the endotracheal tube in the patient in a comfortable, simple and hygienic manner.  
       DESCRIPTION OF THE STATE OF THE ART  
       [0002]     Different laryngoscopes are known in the state of the art, but the improvements implied from the optical light laryngoscope disclosed in European patent application EP-A-1285623 of the same applicant are particularly relevant. The device disclosed in said application allows introducing the endotracheal tube into the patient with fewer risks for the patient due to visualization of the interior of the mouth during intubation, unlike the shaft laryngoscopes used in medicine and which only allowed blind intubation. The laryngoscope of patent application EP-A-1285623 is made up of a single body formed by a first straight section and a curved section after the straight section, this last section not reaching the area under the epiglottis, which blocks the subsequent introduction of the endotracheal tube into the trachea when the epiglottis is introduced or caught in the distal part of the laryngoscope. Said body is internally divided into two closed independent conduits, one for visualizing inside the larynx during the intubation process and the other one for introducing the endotracheal tube into the patient.  
         [0003]     The optical conduit is internally provided with different components which allow visualizing the entry point of the endotracheal tube in the larynx once the laryngoscope is introduced in the patient&#39;s mouth. Said main components are two adjacent reflective surfaces, a first surface located at the beginning of the straight section and a second reflective surface located at the end of said curved section. The end of the optical conduit that is introduced inside the patient also has a permanent transparent sheet to prevent the entry of fluids into said conduit or also a prism located on said end to achieve better visualization of the interior of the larynx. It also has a magnifying lens located on the end of the optical conduit that remains outside the patient.  
         [0004]     After carrying out said laryngoscope to practice, it was observed that the vision of the interior of the larynx achieved through the optical conduit was not optimal and was blocked by the large amount of secretions or fluids existing inside the mouth, therefore the laryngoscope and its elements were studied and designed such that they not only achieved optimal vision of the interior of the larynx, mainly with a greater magnification power and wide-angle view, but also incorporated a device for extracting said excretions, and particularly saliva, that blocked vision.  
         [0005]     No type of laryngoscope is known in the state of the art having an optical system such as the one disclosed and having a device incorporated on it and used when introducing said laryngoscope for extracting the fluids existing in a patient&#39;s mouth. Aspiration probes, which are independent from the laryngoscope and are connected to a manual or electrical compressor responsible for aspirating said fluids, are currently used to extract fluids existing in the mouth.  
       DESCRIPTION OF THE INVENTION  
       [0006]     The optical light laryngoscope object of the present invention is formed by a hollow longitudinal body with a first straight section, a curved section after the straight section, and a second straight section having a smaller length than the first straight section with a separation of said internal cavity into two independent conduits. The longitudinal body may have an approximately rectangular section with rounded vertexes or its section may be circular or elliptical. Said laryngoscope has a distal end that is the first one introduced in the patient&#39;s mouth and is located at the end of the second straight section, this free end coinciding with the outlet of the intubation tube inside the mouth. In this distal area, said laryngoscope has an outlet for the two independent internal conduits, one of the conduits being used for visualization and a second one for introduction and extraction of the intubation tube, said distal part further having means for incorporating the fluid extraction device. The optical conduit entry, from where the health professional visually controls the operation of introducing the laryngoscope into the patient as well as the intubation tube or endotracheal tube into the patient&#39;s trachea from where the tube exits through the distal end of the laryngoscope, is located on the opposite end, or the proximal end, of the laryngoscope.  
         [0007]     The laryngoscope has four surfaces demarcating the hollow interior thereof, two sides, a top surface and a bottom surface. A first side opposite the central interior separation partition demarcates the optical conduit, and a second side opposite the central interior separation partition demarcates the endotracheal conduit or conduit for introducing the intubation tube. The length of the top surface of the laryngoscope has a smaller length than the bottom one since the radius of the top surface of the curved section is smaller than the radius of the bottom surface of the same section, and because the length of the top surface of the second straight section is smaller than the length of the top surface of said section.  
         [0008]     The main drawback resolved by the present invention is to obtain an optical light laryngoscope that allows obtaining an image that is not blocked by the secretions or fluids existing inside the mouth and with optical means allowing obtaining a clear, magnified image with a wide-angle view. A more aseptic introduction of the endotracheal tube into the trachea is achieved with regard to previous laryngoscopes.  
         [0009]     The solution is based on a laryngoscope incorporating a device that allows partially covering the laryngoscope with a flexible sheet, attached thereto and removable, preferably by means of adherent surfaces and which once the laryngoscope is introduced in the patient&#39;s mouth, allows the extraction of contaminating fluids blocking the vision and deposited during intubation on the laryngoscope and especially on the distal end thereof. This laryngoscope with a built-in extraction device is introduced in the larynx and allows a more aseptic introduction of the endotracheal tube into the patient&#39;s trachea since this sheet prevents direct contact of the distal end of the endotracheal tube with the fluids of the mouth. An optical system for the optical conduit of the laryngoscope has further been developed in combination with said built-in fluid or secretion extraction device in the laryngoscope to allow clear, magnified visualization with a wide-angle view along the entire path of the laryngoscope inside the mouth until being located inside the larynx as well as the subsequent introduction of the endotracheal tube into the trachea.  
         [0010]     According to that described above and to solve the drawback considered, a first aspect of the invention refers to a laryngoscope incorporating an extractor device of the fluids existing inside the mouth.  
         [0011]     Said laryngoscope with a built-in fluid extraction device further comprises an optical system formed in one embodiment by the following elements: 
        a first lens located at the beginning of the first straight section of the laryngoscope that allows increasing and transmitting the reflected image,     a second lens located about in the middle of the first straight section to magnify and transmit the image between the first lens and the first reflective element,     said first reflective element located at the beginning of the curved section,     a third lens located between the first reflective element and the second reflective element to optimally obtain the transmission of the image between both reflective elements,     said second reflective element located at the end of the curved section and supported on the same wall of the body of the laryngoscope as the first reflective element, and     a fourth lens located at the end of the second straight section, at the distal end of the body of the laryngoscope.        
 
         [0018]     In another embodiment is it also possible that the optical visualization conduit includes one reflective element or no reflective element and can be replaced by other optical means or systems.  
         [0019]     Furthermore, the optical system can incorporate a prism or prismatic lens on the proximal part of the laryngoscope allowing medical professionals using it to be at an angled position with respect to the shaft of the straight section of the laryngoscope since it deviates vision towards one side and thus is not above the patient&#39;s head. Said prism may be rotational for the purpose of allowing different positions for the health professionals in introducing the laryngoscope with a built-in fluid extraction device.  
         [0020]     The built-in fluid or secretion extraction device in the laryngoscope covers the top surface, the outlet or distal end and it also covers an area of the bottom surface of the laryngoscope, according to the type of adhesion, with a sheet of flexible and malleable, preferably transparent, material. This device is in direct contact with said body of the laryngoscope and with the secretions, the extraction of said fluids being possible when said sheet is extracted. The sheet forming said device is adapted to the shape of the introduced laryngoscope due to its flexibility and is bent over itself, defining two segments. The first segment has two surfaces, the bottom surface being in contact with the body of the laryngoscope and is connected to the bottom surface of the second segment through the top surface. All these connections may be continuous or discontinuous, preferably with an adhesive although rivets, dyes, notches, etc., can also be used. As previously mentioned, the laryngoscope with the fluid extraction device prevents these fluids from obstructing vision during the introduction of the laryngoscope in the patient when adhered to one of the elements of the optical system, since said device covers said distal part of the laryngoscope.  
         [0021]     This laryngoscope with the built-in fluid extraction device allows being able to be completely lubricated, even its distal part, thus preventing the existing problem of generating damages in some of the components of the optical system.  
         [0022]     Another problem solved by the laryngoscope with a built-in fluid extraction device is to prevent the epiglottis from being caught or stuck with the distal end of the laryngoscope while introducing it in the patient&#39;s mouth, specifically with the outlet of either of the two conduits. The built-in extraction device in the laryngoscope moves the epiglottis upwards with the part of the sheet covering the distal end of the laryngoscope, allowing a complete opening of the tracheal opening and allowing vision without obstacles and the subsequent introduction of the endotracheal tube. This problem is also resolved by means of the incorporation of the second straight section in the laryngoscope arranged after the curved section and on the side opposite the first straight section, on the distal end of the laryngoscope, extending the length of the laryngoscope and allowing it to pass under the epiglottis and moving it upwards and towards the tongue, opening the field of vision and the path of the endotracheal tube towards the trachea.  
         [0023]     The endotracheal conduit is located to the right of the optical conduit for the purpose of being adapted to the generalized use of the endotracheal tube by health professionals.  
         [0024]     Another problem the invention solves is to obtain a laryngoscope that allows obtaining a larger size of the image in the first lens. The section of the laryngoscope is increased from an intermediate area in the first straight section to the proximal end of the laryngoscope so that the size of said image in the display or first lens is larger.  
         [0025]     This increased section of the proximal part of the laryngoscope allows a better hold or grip of the laryngoscope with the built-in fluid extraction device by the hand of the health professional on said proximal part.  
         [0026]     The side of said endotracheal conduit of the laryngoscope may have different constructions facilitating the separation of the endotracheal tube in order to allow the comfortable and simple separation of the laryngoscope and the endotracheal tube once the endotracheal tube has been placed in the trachea. Said side of the laryngoscope is defined by a first section with a closed surface close to the proximal end of the laryngoscope, coinciding with the housing for the batteries, followed by a second section with an open surface for introducing and extracting the endotracheal tube, and finally a third section with a variable construction surface allowing the separation of the endotracheal tube when it is necessary, but it also allows maintaining the endotracheal tube in place inside the endotracheal conduit while introducing the laryngoscope.  
         [0027]     The laryngoscope also has a light system formed by a power source, a conductor and a light bulb. The power source is made of standard use extractable batteries, the housing or container of which is located on the most proximal part of the side of the laryngoscope, preferably in the first section of the side of the endotracheal conduit. The fact that the batteries are extractable allows that despite the laryngoscope is used just once, batteries for following intubations can be used. The entire container of the batters can also be extractable such that the containers rather than the batteries can be exchanged between different laryngoscopes.  
         [0028]     Said light bulb is incorporated inside the bottom surface of the distal end of the endotracheal conduits of the laryngoscope in order to reduce the perimeter of the distal end and allow correct adhesion of the fluid extraction device to the laryngoscope, and to prevent the light bulb of the light system from hurting the patient with burns due to the heat emitted by said light bulb.  
         [0029]     The incorporation of the light bulb in said location and its inclined position allows guiding the light emitted by the light bulb in an inclined manner upwards and therefore towards the interior of the trachea, improving the lighting of the trachea with respect to other laryngoscopes generating shadows in the lighting and therefore hindering vision.  
         [0030]     In order to facilitate adhesion of the fluid extraction device to the laryngoscope, taking advantage of the fact that the outer perimeter thereof must be as small as possible and that the endotracheal tube must be guided upwards and towards the left in its exit from the laryngoscope in order to be introduced in the trachea, the laryngoscope has: 
        A wedge-shaped thickening on the side wall of the endotracheal conduit providing a larger support surface for adhesion of the built-in fluid extraction device in the laryngoscope, and a re-routing of the endotracheal tube towards the left and towards the trachea in its exit.     A wedge-shaped thickening on the bottom wall of the endotracheal conduit providing a larger support surface for adhesion of the built-in fluid extraction device in the laryngoscope, a housing for the light bulb, with the subsequent reduction of the distal outer perimeter of the laryngoscope, and a re-routing of the endotracheal tube upwards and towards the trachea in its exit.        
 
         [0033]     It is also possible to extend the central separation partition between the optical conduit and the endotracheal conduit to the end of the laryngoscope by having an inclined top side, said inclination being parallel to the inclination of the end of the side wall of the optical conduit. This extended central partition has two functions. It acts as an additional support for the fluid extraction device and further prevents the epiglottis from moving downwards and being introduced in the conduits should the laryngoscope move once it is introduced in the patient, possibly blocking either the introduction of the endotracheal tube or the visualization of the interior of the patient. Said central partition will aid in keeping the epiglottis in lifted position. 
     
    
     DESCRIPTION OF THE DRAWINGS  
       [0034]     To facilitate the understanding of this invention, 19 figures are attached to the present patent application, the purpose of which is to better understand the grounds on which the invention at hand is based, and for a better understanding of the description of a preferred embodiment taking into account that the nature of the figures is illustrative and non-limiting.  
         [0035]      FIG. 1   a  shows a left outer perspective view of the optical light laryngoscope of the present invention.  
         [0036]      FIG. 1   b  shows a right outer perspective view of the optical light laryngoscope of the present invention.  
         [0037]      FIG. 2  shows a section according to AA of  FIG. 1   b  in which the integrating elements of the vision system are observed.  
         [0038]      FIG. 3  shows the optical system formed by the lenses and mirrors.  
         [0039]      FIG. 4   a  shows a profile view of the laryngoscope on the side of the endotracheal conduit with a flange in contact with and perpendicular to the bottom surface of the laryngoscope and with two projections on the ends of said flange.  
         [0040]      FIG. 4   b  shows a profile view of the laryngoscope on the side of the endotracheal conduit with two flanges, one in contact with and perpendicular to the bottom surface and the other one in contact with and perpendicular to the top surface, demarcating a slot or groove between them.  
         [0041]      FIG. 4   c  shows a profile view of the laryngoscope on the side of the endotracheal conduit with the side closed.  
         [0042]      FIG. 4   d  shows a profile view of the laryngoscope on the side of the endotracheal conduit with two flanges with small dimensions in contact with the top surface of the laryngoscope and two flanges with larger dimension in contact with the bottom surface.  
         [0043]      FIG. 5   a  shows a right perspective view of the distal end of the laryngoscope with the two conduits and the housing for the light point.  
         [0044]      FIG. 5   b  shows a left perspective view of the distal end of the laryngoscope with the two conduits and the housing for the light point.  
         [0045]      FIG. 6  shows two plan views of the device for extracting oral fluids.  
         [0046]      FIG. 7  shows a view of the optical light laryngoscope together with the fluid extraction device.  
         [0047]      FIG. 8   a  shows a perspective view of the fluid extraction device on the laryngoscope with the bottom end of said device adhered to the bottom part of the laryngoscope.  
         [0048]      FIG. 8   b  shows a perspective view of the fluid extraction device located on the laryngoscope with the bottom end of said device adhered to the bottom surface at the outlet of the endotracheal conduit.  
         [0049]      FIG. 9  shows a perspective view of the device in a first phase of the extraction process thereof once the laryngoscope is introduced in the patient.  
         [0050]      FIG. 10  shows a perspective view of the device in a second phase of the extraction process thereof once the laryngoscope is introduced in the patient.  
         [0051]      FIG. 11  shows a perspective view of the device before being completely separated from the laryngoscope and completely extracted from the patient.  
         [0052]      FIG. 12  shows an alternative method of attachment between the first segment of the device and the laryngoscope.  
         [0053]      FIG. 13  shows  FIG. 8   a  inside a patient with the endotracheal tube introduced in the laryngoscope.  
         [0054]      FIG. 14  shows  FIG. 9  inside a patient with the endotracheal tube introduced in the laryngoscope.  
         [0055]      FIG. 15  shows  FIG. 11  inside a patient with the endotracheal tube introduced in the laryngoscope.  
         [0056]      FIG. 16  shows the optical light laryngoscope together with the endotracheal tube inside the trachea of a patient once the fluid extraction device is withdrawn.  
         [0057]      FIG. 17  shows the optical light laryngoscope together with the endotracheal tube inside the trachea of a patient while the laryngoscope is extracted from the patient and laterally separated from the endotracheal tube, the endotracheal tube remaining inside the trachea.  
         [0058]      FIG. 18  shows the optical light laryngoscope completely extracted from the patient and the endotracheal tube inside said patient.  
         [0059]      FIG. 19  shows a perspective view of the distal end of the laryngoscope with the two conduits and the housing for the light point. 
     
    
     DESCRIPTION OF A PREFERRED EMBODIMENT  
       [0060]     The optical light laryngoscope  1  made up of a longitudinal, preferably prismatic body with an approximately rectangular section, has a first straight section  91  divided into a first part with a continuous section and into a second proximal part with a section growing conically from a first area  94 , located between the proximal end  12  of the optical light laryngoscope and the beginning of the curved section  95  towards the proximal end  12 . Said first part is followed by a curved section  92  and the latter is in turn followed by a second straight section  93 , having a smaller length than the first straight section  91 , the end  16  of this second straight section  93  of the laryngoscope  1  being the distal part  16  thereof coinciding with the outlet end of the intubation conduit  15  and with the end of the optical conduit  19 . This distal part  16  is the part that is introduced first in the patient&#39;s mouth. The free end of the first straight section, proximal end  12 , is what remains outside the patient&#39;s mouth, the curved section  92  and the second straight section  93  remaining inside the patient&#39;s mouth.  
         [0061]     The angle formed by the shafts of the first straight section  91  and the second straight section  93  is approximately in the interval between 50° and 110°, being preferably that said angle be 90°. This angle can be found outside the first interval if the anatomical requirements of the patient so require this. Said angle depends on the laryngeal anatomy of the patient and can be affected by age, weight, height, constitution, sex and diseases suffered, among other factors.  
         [0062]     The laryngoscope has four surfaces demarcating the hollow interior thereof, two side surfaces, a top surface  18  and a bottom surface  18   a . A side surface demarcates together with the interior separation partition  10 , the optical conduit and another side surface  14  opposite to the partition or central wall  10  demarcates the endotracheal conduit  15  for introducing the intubation tube  8 , both conduits being parallel. The length of the top surface  18  of the laryngoscope is smaller than the length of the bottom  18   a  due to the fact that the radius of the top surface  18  of the curved section is smaller than the radius of the bottom surface  18   a  of the same section. The distal end  16  further ends with an inclination defined due to a longer length of the bottom surface  18   a  with respect to the top surface  18  on the second straight section  93 .  
         [0063]     The side of the endotracheal conduit is separated into three different sections. A first section  17  begins on the proximal end  12  where the housing for the power source or battery or batteries is located and extends to a first point  94  located on the first straight section  91  and before the curved section  92  begins. Said batteries provide power to the light bulb (not shown) located on the distal end  16  in the housing  30  designed to house the light bulb. The proximal part and side of the beginning of the first straight section of the laryngoscope have been used to house the batteries so as to create a housing  17  including the electrical means for the insertion thereof. The power transmission means are preferably located in the intersection between the partition or central wall  10  and the bottom surface  18   a  of the laryngoscope, inside the endotracheal conduit, from said housing  17  for the batteries to the cavity  30  for the light bulb. Said housing  17  for the batteries is protected by a removable cover. There can be two variants for this housing  17 : 
        One in which the batteries are removable such that once the laryngoscope is used, the batteries are removed in order to recycle the laryngoscope and the batteries are reusable in another laryngoscope.     One in which the housing  17  itself is removable, such that it will not be necessary to remove the batteries but only the entire housing  17  as many times needed. The batteries may further be extractable.        
 
         [0066]     An open second side section  13  for the side introduction and entry of the endotracheal tube  8  into the endotracheal conduit begins after the housing  17  for the batteries, from said first point  94  located on the first straight section  91  and before the beginning of the curved section  92  to a second point  95  located at the beginning of the curved section  92 . Said opening  13  allows introducing the endotracheal tube  8  with no problems, i.e. it allows introducing the endotracheal tube  8  without compression thereof.  
         [0067]     The third section of the side of the laryngoscope can have different configurations and extends from the end of the opening  13  located at the beginning  95  of the curved section  92  for introducing the endotracheal tube  8  to the distal end  16  of the laryngoscope.  
         [0068]     The preferred configuration of this last section of the side of the endotracheal conduit will be the one shown in  FIG. 4   a , which shows a flange  14  that is attached and perpendicular to the bottom surface  18   a  of the laryngoscope, which spans the entire perimeter of the endotracheal tube from the end of said opening  13  to the distal end  16  of the laryngoscope  1 , and defining a cavity  96  between said flange and the top surface  18  of the laryngoscope. The flange  14  has two projections  14   a  on both ends such that the cavity  96  is reduced with the top surface  18 , preventing the exit of the endotracheal tube  8  unless it is compressed. The width of the cavity  96  existing between the flange  14  and the top surface  18  is larger than the cavity between the projection  14   a  of the flange  14  and the top surface  18 .  
         [0069]     A second configuration, shown in  FIG. 4   b , has from the end of the opening  13  to the distal end of the laryngoscope a flange  14   b  attached and perpendicular to the top surface of the laryngoscope and a flange  14  attached and perpendicular to the bottom surface of the laryngoscope, defining a cavity  96  between both flanges which has less width than the diameter of the endotracheal tube  8 , therefore after initial compression of the tube  8  it is possible to extract it from inside the endotracheal conduit.  
         [0070]     A third proposal for the configuration of the third section of the side of the endotracheal conduit,  FIG. 4   c , consists of the latter being closed by a wall  14   d.    
         [0071]     Another possible configuration is the arrangement of flanges  14   a  at the points in which the tube  8  is supported during its introduction in the endotracheal conduit  15 . One example of said construction can be seen in  FIG. 4   d . The advantage of the options with flanges ( FIGS. 4   a  and  4   d ) over the option of the cavity  96  through the entire length of the laryngoscope ( 4   c ) is that it allows a simpler lateral extraction and separation of the tube  8  since it is not necessary to compress it during the entire run during its side extraction from the laryngoscope  1 . The tube  8  is held in place with the flanges, preventing the endotracheal conduit  15  from coming out and when it is extracted, there are certain compression flanges, preferably a flange  14   a  at the beginning of the second section  95  of the side of the endotracheal conduit  15 , and another flange  14   a  on the distal end  16 . It is possible to design other flange arrangement combinations in addition to those shown with a larger or smaller separation between them.  
         [0072]     Once the endotracheal tube  8  is introduced in the endotracheal conduit through the opening  13  of said tube  8 , it slides inside the laryngoscope  1  parallel to the optical conduit to the distal end  16  of the laryngoscope.  
         [0073]     Said optical conduit is used for visual control of the process of introducing the laryngoscope  1  in the patient and subsequently for checking the correct introduction of the intubation tube  8  in the patient&#39;s trachea. In order to achieve that this introduction process is as fast and safe as possible, the laryngoscope has a typical construction of its optical system, being formed in one embodiment by at least four lenses and two reflective elements, as well as an additional prism located on the proximal end.  
         [0074]     The first lens  21  with its two convex surfaces is located at the beginning of the first straight section  91  of the laryngoscope, and its function is, in combination with a second lens  22 , to magnify and transmit the image reaching it reflected from the distal end  16  of the laryngoscope. The second lens  22  having a convex surface and a concave surface, an located in the first straight section  91  before the beginning of the curved section  92 , has functions, in combination with the first lens  21 , of magnifying and transmitting the image between the first reflective element  24  and said first lens  21 . After this lens  22  there is a first reflective element, preferably a plane first-surface mirror  24 , almost at the beginning of the curved section  92  and supported on the bottom surface  18   a  of the laryngoscope inside the optical conduit. The third lens  23 , with one concave surface and the opposite surface convex, is located between the two reflective surfaces  24 ,  24   a , and its function is to transmit the image between the two reflective elements  24 ,  24   a . The second reflective element  24   a  is located almost before the end of the curved section  92 , supported on the bottom surface  18   a  of the laryngoscope  1  inside the optical conduit and, like the first reflective element  24 , is preferably a plane first-surface mirror. The fourth preferably prismatic lens  25  has a convex surface and the opposite surface is planar, with a wide-angle function and the function of changing the direction of the image located at the beginning of the second straight section  93 .  
         [0075]     It is obvious that said optical system can be replaced with another one containing one or no reflective surface.  
         [0076]     For visualization at the entry of the laryngoscope to be greater and in order to be able to introduce a larger display, first convex concave lens  21 , the section of the laryngoscope has an increase in its section from almost a point  94  located in the first straight section  91  and before the beginning of the curved section  92  to the proximal end  12  of said straight section  91 .  
         [0077]     The laryngoscope can optionally incorporate in a removable and rotational manner on its proximal end  12 , a prismatic end  26  with both surfaces being planar in order to achieve an ergonomic position for the health professionals while using the laryngoscope, therefore it is not necessary to be above the head of the patient to see the reflected image.  
         [0078]     The distal end  16  of the laryngoscope has been modified so as to allow the incorporation of the fluid extraction device while at the same time it achieves guiding the endotracheal tube  8  to the exit of the endotracheal conduit  15  towards the trachea “O” and to also allow incorporating a light bulb in the thickness of the bottom surface  18   a , reducing the outer perimeter of the distal end of the laryngoscope with a built-in extraction device and being able to guide the light beam of the light bulb towards the trachea “O”. The endotracheal conduit  15  in the second straight section  93  of the laryngoscope has its bottom surface  32  and side surface  31  thickened. The bottom surface  32  is thickened, being lifted and determining a housing  30  for the light bulb and the side surface  31  is inclined and thickened towards the interior of the laryngoscope on its distal end, both inclinations allowing the correct guiding of the tube  8  towards the trachea “O”. Said inclined surfaces define wedges having a larger surface than the rest of the contour  33  of the distal end  16 , allowing adhesion of the built-in fluid extraction device in the laryngoscope by increasing the contact surface between the laryngoscope and said device.  
         [0079]     The central separation partition  10  between the optical conduit  19  and the endotracheal conduit  15  can also be extended to the end of the laryngoscope by having its top side inclined, said inclination being parallel to the inclination of the end of the side wall of the optical conduit  19 . This extended central partition  10  has two functions, acting as an additional support for the fluid extraction device, and additionally preventing the epiglottis from dropping down and being introduced in the conduits in the event that said laryngoscope moves once the laryngoscope is introduced in the patient, possibly blocking the introduction of the endotracheal tube or blocking visualization of the inside of the patient. Said central partition  10  will aid in keeping the epiglottis raised.  
         [0080]     The built-in oral fluid extraction device in the laryngoscope is made up of a sheet of preferably transparent flexible and malleable material T made up of two segments  4 ,  5 . Said segments are attached in their extended form by a bending surface  43  and have two surfaces each.  
         [0081]     In order to incorporate the fluid extraction device in the laryngoscope described, the bottom surface  51  of the first segment  5  is in contact with the top surface of the body of the laryngoscope  18  and the top surface  52  of said first segment  5  is in contact with the bottom surface  41  of the second segment  4 .  
         [0082]     The contact between the different surfaces can be carried out by means of different non-permanent attachment means such as an adhesive or notches. Said attachment means can be arranged on the different surfaces in a constant manner, i.e. the attachment means are arranged along the entire contact surface, or in an intercalated manner, i.e. the attachment means are arranged in intervals along the contact surface.  
         [0083]     The bottom surface  51  of the first segment  5  is in contact with the top surface of the body of the laryngoscope  18 , preferably through adhesive areas  53  intercalated in said bottom surface  51  of said first segment  5  with other non-adhesive surfaces  54 .  
         [0084]     The top surface  52  of said first segment  5  is in contact with the bottom surface  41  of the second segment  4 , preferably through adhesive areas  44  intercalated with non-adhesive surfaces  45  on said bottom surface  41  of said second segment  4 .  
         [0085]     Once the sheet T is bent along its bend line  43 , the device has two ends, a top end  47  and another bottom end  62  coinciding with the bend line  43 . The bottom end  62  is located on the bottom surface  18   a  and close to the distal end  16  of the laryngoscope  1  and after passing through said distal end  16  of the laryngoscope  1 , covering the outlet of the optical conduit  19  and the endotracheal conduit  15 , it extends to a point located on the top surface  18  of the laryngoscope  1  and close to the proximal end  12  of the first straight section, the top end  47  of the sheet T being located there. The top end  47  of the sheet T, formed by the two ends of the first segment  5  and second segment  4 , has a fixing means  48 , preferably a ring, as an extension of the second segment  4 .  
         [0086]     A variant of the previous option for arranging the sheet T is to make the bend line  43  to coincide with the distal end  16  of the bottom surface  18   a , such that the fold line ( 43 ) of the sheet (T) coincides with the attachment edge between the bottom surface ( 18   a ) and the distal end ( 16 ). The larger support surface provided by the side wedge  31  and the bottom wedge  32  located on the distal end  16  of the laryngoscope at the outlet of the endotracheal conduit  15  is thus used.  
         [0087]     The bottom end  62  of the sheet T must preferably be located in a space where the adhesion of the sheet of the first segment  5  to the bottom surface  18   a  of the body of the laryngoscope  1  is assured, while the top end  47  of the sheet T must preferably be located between the middle area of the first straight section of the laryngoscope  1  and the proximal end  12  thereof.  
         [0088]     The previous arrangement is recommended for safety reasons since it allows visually controlling the two segments of the sheet T. Should one of the segments break during the extraction of the device, the situation of the other segment can always be controlled because the two ends are always visible from outside the mouth, thus preventing any fragments of the device from being introduced inside the larynx.  
         [0089]     The width of the second segment  4  is preferably less than the width of the first segment  5  so as to allow both segments from being easily released during their use, since the contact area between them is smaller than the area existing between the first segment  5  and the body of the laryngoscope  1 . The second segment  4  having a smaller width will preferably be centered with respect to the axis of longitudinal symmetry of the sheet T.  
         [0090]     The incorporation of the device T in the laryngoscope  1  consists of first placing the top surface  52  of the first segment  5  in contact with the bottom surface  41  of the second segment  4  by means of any of the previously mentioned means, adhesion or notches. Once both surfaces of the two segments have been placed in contact, the bottom surface  51  of the first segment  5  will be placed in contact with the body of the laryngoscope  1 , the laryngoscope thus being ready for use.  
         [0091]     Once the laryngoscope incorporates the device, the assembly of the laryngoscope with the endotracheal tube  8  preloaded in the endotracheal conduit  15  is then introduced in the mouth of the patient, first introducing the distal end  16  of the laryngoscope  1 .  
         [0092]     Prior to this operation it is possible to lubricate all the surfaces of the laryngoscope to facilitate the introduction thereof in the mouth, even its distal end  16  can be lubricated with the risk that the lubricant is introduced in the optical conduit  19  of the laryngoscope  1 , which would hinder vision through the optical system, since it has the fluid extraction lamina covering the entire distal end thereof.  
         [0093]     When introducing the laryngoscope in the larynx, the fluid extraction device pushes the epiglottis upwards, the laryngoscope sliding along its bottom part and thus being placed in its proper position opposite to the trachea, allowing perfect vision of the opening of the trachea in order to be able to see how the endotracheal tube  8  is introduced in it.  
         [0094]     When the introduction of the laryngoscope into the larynx ends, the accumulated fluids, saliva  6  and other fluids, will be deposited on the sheet T and particularly on the top surface  52  of the first segment and the top surface  42  of the second segment  2 , and when the sheet T with the fluids  6  accumulated thereon is removed, correct visualization and a more aseptic introduction of the endotracheal tube are allowed.  
         [0095]     To remove said fluids, it is enough to pull on the ring  48 , which will cause the bottom surface  41  of the second segment  4  to detach from the top surface  52  of the first segment  5 , since the attachment between these two surfaces is weaker than the attachment between the surface  51  and the body of the laryngoscope  1 , until reaching the bend line  43 . By continuing to pull on said tab  48 , an inverted C or inverted wave movement is generated which will envelope the fluids  6  deposited on the top surface  52  of the first segment  5  as the bottom surface  51  of the first segment is separated from the body of the laryngoscope  1  until reaching the top end of the sheet  47  where it will completely separate. Therefore the extraction device T of the laryngoscope  1  can be withdrawn with the accumulated fluids  6 . As can be deduced from the foregoing, the functions of the device are: 
        Allowing lubrication of the distal end  16  of the laryngoscope  1  without staining or damaging the optics.     Preventing the different existing fluids from staining or contaminating the endotracheal tube  8 .     Lifting the epiglottis while introducing the laryngoscope  1  in the larynx.     Extracting the existing fluids  6  inside the mouth at the time of intubation.     Allowing a more aseptic introduction of the endotracheal tube  8  in the trachea O.        
 
         [0101]     This enveloping movement for extracting the inverted C-shaped sheet T also allows the partial extraction of other fluids inside the larynx and which had not been deposited on the sheet T.  
         [0102]     The laryngoscope  1  can thus be introduced with perfect visualization of the interior of the trachea “O” and better aseptic conditions of the endotracheal tube in the moment of intubation, to subsequently withdraw said laryngoscope  1  laterally, maintaining the endotracheal tube  8  inside the trachea “O”.