The most common complication of double lumen tube intubation is malposition of double lumen tube which is prevented by fibreoptic bronchoscopy. Trouble-shooting techniques for DLT inseion include using fiberoptic bronchoscope to cannulate bronchus and then rail road tube over the scope (perhaps the gold standard approach) use stylet to help place using a bougie as an introducer clinically check ventilation once changes have been made between normal ventilation and isolated lung ventilation once tracheal cuff below cords, rotate tube towards bronchus that is to be cannulated, turn patient's head to opposite side, gently slide tube down until resistance felt