TREATMENT/SURGICAL PROCEDURE DONE

Date: 15/01/2024
Procedure: Airway Assessment and Montgomery tube insertion
Surgeons: Dr. Vidhu Sharma
Dr. Siddharth Manoj
Dr. Bumai Raina, Dr Anup Das
Notes:
 Under GA Patient positioned, parts painted and draped.
 Local infiltration given with 1:2 Lakh adrenaline + 2 % Lignocaine over
peristomal site. Peristomal granulation tissue was seen.
 Tracheostomy tube 3.5 mm single lumen cuffed tube in situ
 Endoscopic assessment was done by direct laryngoscope and through
stomal site using zero degree endoscope.
 Mild Suprastomal granulation tissue with antero-posterior collapse seen ,
completely occluding the suprastomal site. Subglottis normal.
 Tracheostomy tube replaced with 4.0 mm flexometallic endotracheal tube
 Tracheostomy stomal site incision extended 1cm superiorly and
inferiorly.
 Skin and subcutaneous tissue retracted, granulation tissue cauterised.
 Coblation assisted granulation tissue release done under direct
laryngoscopic and endoscopic guidance.
 Montogomery “T” tube tracheal stenting (size 8) done via the
tracheostoma site and secured in position.
 Check endoscopy done through zero degree endoscope and T-Tube was
found approximately 1 cm below the TVC. Haemostasis achieved.
 Subcutaneous tissue and skin sutured in layers using vicryl and silk.
Dressing done.