S172 – Primary TE Puncture in Stapler-Assisted Total Laryngectomy

Abstract

Objectives

1) To present a novel method for placement of a primary tracheoesophageal puncture (TEP) following stapler assisted laryngectomy. 2) To discuss the challenges and pitfalls of TEP placement following stapler-assisted laryngectomy.

Methods

A case series of 10 consecutive patients treated with stapler-assisted laryngectomy who underwent primary tracheoesophageal puncture at the time the initial surgery was conducted. Because stapler-assisted total laryngectomy poses a unique challenge for the placement of concurrent TEP, we developed a novel technique whereby flexible esophagoscopy was performed and under direct visualization, a modified Seldinger technique was employed with a Russel percutaneous gastrostomy placement kit to allow creation of a TEP. This series was performed at a single academic institution. The primary outcome measured was ability of alaryngeal speech.

Results

10 consecutive cases of primary tracheoesophageal puncture in stapler-assisted laryngectomy achieved alaryngeal speech.

Conclusions

The method described provides simple, safe, and repeatable results that facilitate alaryngeal speech in patients undergoing primary tracheoesophageal puncture and stapler-assisted laryngectomy.