This chapter provides an in-depth analysis of the ProtekDuo® (LivaNova, London) dual-lumen cannula’s application in extracorporeal membrane oxygenation (ECMO), focusing on the procedural techniques of cannulation, weaning, and decannulation. The discussion will provide the step-by-step methodologies for inserting and removing the cannula, drawing from current clinical practices. Further, the chapter will explore the range of ECMO configurations that the ProtekDuo® cannula enables. It will examine how these configurations can be tailored to the evolving clinical requirements of patients, thereby enhancing the adaptability and effectiveness of ECMO therapy. This analysis will be anchored in the latest literature, providing a contemporary overview of patient outcomes and current practices. Lastly, the chapter will project into the future of the cannula technology for venopulmonary (VP) ECMO and other configurations. It will review ongoing research and development efforts, speculate on potential technological breakthroughs, and discuss the implication of these innovations for clinical practice. This forward-looking perspective will aim to inform and inspire continued advancement in ECMO therapy and technology.