Abstract: An apparatus and method for accomplishing simultaneous bronchoscopy and airway instrumentation and securing the instrument in place using an adjustable threaded gastight seal. The apparatus consisting of a hollow elongated manifold for simultaneous fiberoptic bronchoscopy through a fiberoptic port (4) and introduction a secondary tubular instrument (2) through a threaded secondary instrument port (5) while maintaining mechanical ventilation of a intubated patient using a ventilation port (7) and endotracheal tube connection port (6). The secondary instrument port (5) is constructed in a manner to allow introduction of a tubular instrument into the airway and form an adjustable gastight seal.