Translaryngeal tracheostomy: Technique and early experience

Translaryngeal tracheostomy is a new type of minimally invasive technique for bedside tracheostomy in intensive care patients. After percutaneous puncture of the trachea below the first tracheal ring, a conic tracheal cannula is fixed to an orally forwarded guide wire. The cannula is then pulled through in orthograde fashion set up, rotated and pushed forward caudally Among the first 25 translaryngeal tracheostomies in 24 patients, only two complications appeared: one misplacement of the cannula and one infection of the stoma. During a median apnoea time of about 80 s an average PaCO2 increase of 8.0 +/- 6.8 mmHg was documented; hypoxias could not be seen. Translaryngeal tracheostomy seems to be an appropriate alternative to established tracheostomy methods.