Schmutz A, et al. - Researchers investigated the feasibility of LMA Gastro, a new supraglottic airway device, developed especially for upper gastrointestinal endoscopy and interventions, in patients with ASA physical status ≥ 3 undergoing advanced endoscopic procedures. They retrospectively analyzed data from 214 patients who received anesthesia for gastroenterological interventions. Following inclusion criteria were followed: upper gastrointestinal endoscopic interventions, airway management with LMA Gastro and ASA status ≥ 3. They assessed 31 patients with ASA physical status ≥ 3, undergoing complex and prolonged upper gastrointestinal endoscopic procedures. Seven endoscopic retrograde cholangiopancreatographies, 7 peroral endoscopic myotomies, 5 percutaneous endoscopic gastrostomies and 12 other complex procedures (eg endoscopic submucosal dissection, esophageal stent placement etc.) were performed. Using the LMA Gastro led to suvvessful management of 27 of these patients. Easy placement of the LMA Gastro was possible. With no difficulty, positive pressure ventilation was performed. The endoscopists rated the feasibility of the LMA Gastro for endoscopic intervention as excellent. Outcomes support the feasibility of using the LMA Gastro during general anesthesia for advanced endoscopic procedures in high-risk patients.