Inclusion Criteria:

   - Scheduled for elective surgery with an estimated duration of 30 to 120 minutes

   - American Society of Anesthesiologists (ASA) status I-III

   - Aged 18 to 65 years.

   - Body mass index (BMI) ≥ 35 kg/m2

Exclusion Criteria:

   - A history of difficult intubation;

   - Immobilized cervical spine;

   - Oxygen saturation less than 95% at room air;

   - A history of uncontrolled gastroesophageal reflux or hiatus hernia;

   - A history of ulcer surgery including vagotomy;

   - Previous gastric bypass surgery;

   - Diabetic gastroparesis;

   - Patients with known coagulation disorders (e.g. hemophilias, von Willebrand disease,
   factor V leiden diseases) or on systemic anticoagulation drugs (e.g. continuous
   heparin infusion); Patients with abnormal coagulation tests will be also excluded.
   However, asymptomatic patients will not be tested on any coagulation disorders.

   - Any pathologies of the mouth, pharynx or larynx, the access to the airway is
   restricted, or a difficult tracheal intubation is anticipated.

   - Pregnant or breast-feeding (pregnancy status will be confirmed by a pregnancy test, as
   it is standard for all surgical procedures at the University hospital).