We respectfully do not agree that DLET might limit the vision of anatomic structures. The DLET correctly positioned at the level of vocal cords allows endoscopic vision from this point to the carina. The DLET is made of transparent polyvinyl chloride, allowing endoscopic vision of mucosal lesions and avoiding endoscopic tip flexure. In our opinion, the technique proposed by Ferraro et al4,5 has some limitations: (1) It negatively affected ventilation, since Paco2 increased 4.5 (3.7 SD) mm Hg and Pao2 decreased 75 (33 SD) mm Hg during PDT; and (2) it is likely to interfere with endoscopic vision and procedural maneuvers. In fact, since the uncuffed endotracheal tube is not adequately secured and fixed in the trachea, like DLET, it may be abruptly displaced by the pressure exerted during the PDT maneuvers. Additionally, at cannula insertion, the DLET may be partially withdrawn, but the flexible fiber-optic bronchoscope can remain in place, ensuring continued endoscopic vision.