In 1992 the Laryngeal Mask Airway (LMA) was approved for sale in the United States. Created earlier in the 1980's by Dr. Brain (I am not making this up, that is his real name), the LMA device provided a direct seal of the oropharynx to the trachea. Thus, not every patient needed to have an endotracheal intubation for a surgical procedure needing general anesthesia. It has also been used in placing emergency airways. This device has revolutionized anesthesia practice and some have stated that it is the most important invention in Anesthesia in the past 25 years.