A new tracheal intubation device is available. The 'Shikani Seeing Stylet' is a new, inexpensive, reusable high resolution endoscope with a malleable stainless-steel sheath which can be inserted through a tracheal tube allowing intubation to be performed under direct vision. We have assessed this new device on 20 patients (ASA I-II; age 25-67) scheduled to undergo elective surgery with tracheal intubation. We measured heart rate (HR), non invasive blood pressure (NIBP), oxygen saturation (SpO(2)) and end tidal carbon dioxide (ETCO(2)) at three different times: T(0) (induction of anesthesia), T(1) (beginning of intubation procedure), T(2) (end of intubation procedure); we also recorded the time interval between T(1) and T(2). All patients were successfully intubated with the device. Eleven patients were intubated at the first attempt (T(1)-T(2) mean time=8. 65 s); three patients were intubated at the first attempt using cricoid pressure (T(1)-T(2) mean time 11.6 s); four patients were intubated at the second attempt (T(1)-T(2) mean time=36.5 s); two patients were intubated at the third attempt (T(1)-T(2) mean time=54. 5 s). The HR, NIBP, SpO(2) and ETCO(2) remained fairly stable. On the basis of our preliminary experience with 20 patients, the 'Shikani Seeing Stylet' seems to be a promising adjunct for airway management.