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81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

12.05. - 16.05.2010, Wiesbaden

How Big Should Be A Tracheostomy In The Era of Minimally Invasive Surgery?

Meeting Abstract

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  • corresponding author Marco Tesseroli - Hospital Regional do Oeste, Chapecó, Brazil
  • Andreza Almeida - Universidade Comunitária UNOCHAPECO, Chapecó, Brazil
  • Lhia Magro - Universidade do Vale do Itajaí, Itajaí, Brazil

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 81. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Wiesbaden, 12.-16.05.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10hnod085

DOI: 10.3205/10hnod085, URN: urn:nbn:de:0183-10hnod0854

Published: April 22, 2010

© 2010 Tesseroli et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Introduction: Tracheostomy is one of the oldest surgical procedures reported for over a millennium. The principles of the “surgical tracheostomy” were described at the beginning of the 20th century and these have remained to the present day without any significant technical change. Classically, "surgical tracheostomy” is performed with incisions ranging from 3 to 5cm, with wide exposure and traction of pre-tracheal muscles. In the era of minimally invasive surgery, we proposed a new approach to perform a tracheostomy.

Methods: Between May 2006 and September 2009 were performed 73 consecutive tracheostomies by the same Head and Neck surgeon. Fifty two patients were operated on an elective basis, while 21 were operated under urgency conditions. Local anesthesia was used in all cases of urgency and in 32 elective cases. The technique used consisted of incision size equal to the tube to be used (internal tube diameter between 7.0 and 8.0mm) and vertical dissection direct toward the trachea, without the classic dissection of pre-tracheal muscles. The trachea was opened without the need for tracheal ring resection or suture, also not used skin sutures.

Results: All cases were performed with the proposed incision. There were no cases of bleeding, infection, or tracheal stenosis. Two patients developed subcutaneous emphysema of the neck and superior chest, without any clinical compromise, regressing spontaneously.

Conclusions: The technique proved to be safe, with less tissue dissection than the classical technique. As minimally invasive thyroidectomy, a more complex procedure that can be done on 1.5cm incision, we believe that tracheostomy must be performed in a less invasive way.