A novel technique in placing a Fogarty catheter in the upper limb of a Montgomery T-tube for a patient undergoing tracheal resection.

摘要

A number of ventilation strategies exist for patients with Montgomery T-tubes during tracheal resection. We describe a novel technique with antegrade passage of a Fogarty catheter through the mouth, guided by a suture to the upper limb of the T-tube. Written consent for publication of this article was obtained from the patient.A 59-yr-old female patient (weight 89 kg, height 173 cm) diagnosed with idiopathic tracheal stenosis was scheduled to undergo tracheal resection. A computed tomography scan of her neck showed tracheal stenosis 1.3 cm in length located 1.5 cm below the glottis. In the operating room, standard monitoring was applied and the patient was anesthetized with remifentanil, propofol bolus and infusion, and rocuronium. The patient's lungs were ventilated with 100% oxygen with bag and mask for two minutes. Serial rigid bronchoscopies were performed up to 8.0 mm, and a size 6.5 mm (internal diameter) armoured tracheal tube was inserted into the trachea under direct laryngoscopy.