HOW I DO IT / HOW I DID IT SURGICAL PROCEDURES

 

 TRACHEOSTOMY

 

Operative Technique:

§      Patient supine

§      Slightly hyperextended the neck by placing a roll under the patient’s shoulder

§      Asepsis antisepsis

§      Sterile drapes placed

§      Local anesthesia infiltrated

§      Palpate for the five midline landmarks

o       Mental protruberance

o       Body of hyoid bone

o       Laryngeal prominence of the thyroid cartilage

o       Cricoid cartilage

o       Suprasternal notch

§      Vertical incision midway between the cricoid cartilage and jugular notch provides better exposure

§      Skin, subcutaneous tissues and strap muscles are retracted laterally to exposed the thyroid isthmus

§      The isthmus maybe divided and ligated or retracted upward

§      Dissect and cut the pre-tracheal fascia for better exposure

§      Identify the cricoid cartilage

§      Count the rings down the cricoid cartilage

§      With a tracheal hook, the trachea is pulled up

§      Incised and spread the tissue between the second and third tracheal rings

§      Tracheostomy tube inserted

§      Skin closed