The suction-assisted endoscopic suture technique: A simple method for endotracheal suturing.
Endoscope
bronchoscopy
migration
silicone stent
subglottic stenosis
tracheal stenosis
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
21
03
2019
revised:
03
07
2019
accepted:
08
07
2019
pubmed:
3
8
2019
medline:
26
8
2020
entrez:
3
8
2019
Statut:
ppublish
Résumé
Silicone stents are commonly employed to treat subglottic stenosis. A frequent complication is the tendency of stents to migrate. As such, various techniques to secure stents have been developed over the years, none of which have gained large popularity. We present a novel, low-cost, and easy-to-perform technique herein. To describe a novel surgical technique to secure silicone stents and prevent migration for management of subglottic stenosis. After standard excision and dilation of stenotic portions in the subglottic or trachea. A silicone stent is introduced in a standard fashion. To secure the stent, an 18-G needle loaded with braided suture is inserted through skin, trachea, and stent. Endoscopic visualization then permits the surgeon to grasp the suture with forceps. A separate transcutaneous puncture site is performed with an 18-G needle attached to a 10-cc syringe (plunger removed) and blue tip suction within the empty syringe, creating an airtight suctioning tool. The grasped suture is gently introduced into the eye of the needle and quickly travels into the 10-cc syringe with suction assist, leaving both extracorporeal ends of the suture to tie. This stitch has been employed on seven occasions on four patients. There have been no episodes of stent migration. A laboratory model found the 18-G needle and braided 3-0 suture performed optimally. We present a novel surgical technique to secure silicone stents in management subglottic or tracheal stenosis. Level 4 Laryngoscope, 130:E346-E348, 2020.
Sections du résumé
BACKGROUND
Silicone stents are commonly employed to treat subglottic stenosis. A frequent complication is the tendency of stents to migrate. As such, various techniques to secure stents have been developed over the years, none of which have gained large popularity. We present a novel, low-cost, and easy-to-perform technique herein.
OBJECTIVES
To describe a novel surgical technique to secure silicone stents and prevent migration for management of subglottic stenosis.
MATERIALS AND METHODS
After standard excision and dilation of stenotic portions in the subglottic or trachea. A silicone stent is introduced in a standard fashion. To secure the stent, an 18-G needle loaded with braided suture is inserted through skin, trachea, and stent. Endoscopic visualization then permits the surgeon to grasp the suture with forceps. A separate transcutaneous puncture site is performed with an 18-G needle attached to a 10-cc syringe (plunger removed) and blue tip suction within the empty syringe, creating an airtight suctioning tool. The grasped suture is gently introduced into the eye of the needle and quickly travels into the 10-cc syringe with suction assist, leaving both extracorporeal ends of the suture to tie.
RESULTS
This stitch has been employed on seven occasions on four patients. There have been no episodes of stent migration. A laboratory model found the 18-G needle and braided 3-0 suture performed optimally.
CONCLUSIONS
We present a novel surgical technique to secure silicone stents in management subglottic or tracheal stenosis.
LEVEL OF EVIDENCE
Level 4 Laryngoscope, 130:E346-E348, 2020.
Substances chimiques
Silicone Elastomers
0
Types de publication
Journal Article
Technical Report
Langues
eng
Sous-ensembles de citation
IM
Pagination
E346-E348Informations de copyright
© 2019 The American Laryngological, Rhinological and Otological Society, Inc.
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