There is a plan to do the second phase of the study. This will include a total of 50 patients with anticipated difficult airway (limited mouth opening, restricted neck movement, Mallampati 4, thyromental distance < 6 cm, BMI ≥ 40 kg/m2). All patients will be adult surgical candidates aged 18-80 years, ASA I- III, presenting for elective surgery who require general endotracheal anesthesia. We hypothesize that the C-MAC may be a safer and suitable alternative device for both routine and difficult laryngoscopy and tracheal intubation.