Transnasal oesophagoscopy‐guided tracheoesophageal puncture. A novel method using the mini‐tracheostomy kit

New device for single-stage in-office secondary tracheoesophageal puncture: Animal studies

“…First, for humane reasons the animal experiments were carried out while they were under general anesthesia, whereas in humans, the objective would be to perform the procedure with the patient under local anesthesia. However, our current method of choice for secondary TEP, which involves passing a mini‐tracheostomy tube through the trachea into the esophagus under TNE guidance, is similar in many ways . We perform this using topical anesthesia in the nose and throat to facilitate TNE, and local anesthetic injected into the posterior tracheal wall at the puncture site.…”

“…Visualizing the esophageal lumen has a number of advantages, which include (1) avoidance of false passage formation, (2) minimizing posterior esophageal wall trauma, (3) accurate positioning of the puncture in the middle of the esophageal lumen, and (4) ability to negotiate anatomic distortion more easily. Using TNE, the voice prosthesis can be placed in antegrade fashion after creation of puncture using a scalpel blade or the Seldinger technique with dilators …”

“…In 2010, our group described the use of the mini‐tracheostomy kit to perform TNE‐guided TEP . An advantage of this technique was that the mini‐tracheostomy tube, which was inserted over a dilator using the Seldinger technique, provided a conduit across the tracheoesophageal wall.…”