There are airways and thyroid cartilage located in front of the vertebral bodies and the right and left uncinate processes of the vertebral bodies in the deeper part. This anatomical structure prevents the outer tube tip from turning toward the ipsilateral direction, making the contralateral approach less difficult than the ipsilateral approach. Therefore, the contralateral approach is usually used for patients with unilateral hernia; however, the ipsilateral approach is also secure. b, bronchial airway; e, esophagus; p, uncinate process; C, contralateral approach; I, ipsilateral approach.