Prospective evaluation of the retrograde percutaneous translaryngeal tracheostomy (Fantoni procedure) in a surgical intensive care unit: Technique and results of the Fantoni tracheostomy

Abstract

Our experience shows that the major advantage of the use of the Fantoni tracheostomy is the retrograde dilatation of the stoma, which prevents serious complications compared with other techniques.

Tracheal visualization during tracheostomy: the dark side of the moon or just the moon and mars

“…This technique was then modified allowing to perform the tracheal puncture by safely placing a small calibre tracheal tube and performing the tracheal puncture under transillumination through a direct fiberoptic bronchoscopy guidance, using it during the rotation of the cannula caudally and then reinserting the fiberoptic scope inside the cannula, to detect the correct position of the tip that was usually 2 to 3 cm from the carina. 12 The TLT has never reached great popularity between the intensivists' world, as it requires higher training to avoid major complications because of the rotation of the cannula inside the tracheal lumen. 13 Despite this, the technique forced the operators to perform the procedure under continuous visualization of the tracheal lumen through a bronchoscopic vision, in all different phases of the tracheostomy: from the choice of the puncture point into the anterior wall of the trachea (using an L-view), to the positioning of the tracheostomy cannula (using a T-view), before considering it ready for use and connecting to the ventilator.…”

Fantoni’s Tracheostomy using Catheter High Frequency Jet Ventilation

“…It is based on the translaryngeal (retrograde) principle of tracheal dilation by the tip built into the tra cheostomic introductory tube and a cannula from the tra chea transcutaneously outwards (2)(3)(4). The advantage of TLT is the technique of minimal invasiveness and minimal damage to the trachea, which can be a problem at surgical and punctural dilatation tracheostomy (5). Contrary to the punctural dilatation tracheostomy it is not necessary to use forceps or other expansion devices, causing further damage to the surrounding tissue.…”