Secondary tracheoesophageal puncture with a flexible transillumination device: a new technique and its outcomes

Abstract

ObjectivesThis study aims to describe a new secondary tracheoesophageal puncture technique with voice prosthesis insertion under local anesthesia with a low-cost device and evaluate its outcome. MethodsWith a transoral flexible transillumination device of aluminum of 2.3 mm with fiberoptic light, the esophagus’s anterior wall is visualized through the tracheostomy. A tracheoesophageal fistula is made with a blade and passed through the fistula. Then a bent trocar is introduced into the lumen using the device as a guidewire. Once in the lumen, a thin guide wire is passed through up to the mouth. The voice prosthesis is positioned with retrograde insertion. Then, the patient is discharged without hospitalization. Results15 patients submitted to this technique had a successful surgical outcome. There were no complications as pneumothorax, esophageal perforation, bleeding, or hospitalization. ConclusionThe new device is feasible under local anesthesia.