Date of Surgery -
Preop Diagnosis - prolonged ventilator dependency, respiratory failure
Postop Diagnosis - Same
Surgeon - Dr. Luk / Dr. Tran
Assistant Surgeon -
Anesthesia - General anesthesia
Estimated Blood Loss - Minimal
Complication - none
Findings - normal anatomy
Specimen - none
Device use - #8 Cuffed Shiley Tracheostomy
Procedure performed - tracheostomy
Indication - respiratory failure and prolonged need for mechanical ventilation
Patient comes in with the above diagnosis and was consented for the above procedures. Risks, benefits, and alternatives were discussed with patient, which includes, but are not limited to, postoperative bleeding, wound infection, hematoma, tracheomalacia, or need for further procedures or workup. Other Complications may include deep vein thrombosis(blood clots), as well as other side effects affecting other organ systems such as the heart or lungs, and in rare circumstances, death as a result of the above complications. The patient and or family members understand and agrees to proceed with the proposed procedure.
The Patient was given preoperative antibiotics.
After consent was obtained, the patient was brought to the OR and underwent general anesthesia. The patient was prep and draped in the standard manner.
Timeout was performed and all was in agreement.
A number 15 scalpel was used to make a linear incision in the midline of the neck about 1 cm below the thyroid cartilage.
Dissection was carried down to the thyroid muscle using the electrocautery.
The muscle was split in the center.
Bleeding edge of skin, muscle or thyroid was cauterized.
The trachea was identified and skeletonized.
An incision was created in the trachea using a number 11 blade 2 rings below the cricoid membrane.
The trach spreader was used to enlarged the opening.
Anesthesia was asked to then back the endotracheal tube slowly until the tip of the ET tube rested just above the incision.
Next, a number 8 Shiley, cuffed tracheostomy tube was carefully inserted into the trachea under direct vision. The obturator was removed and the innter cannular was inserted. The balloon was inflated. The tracheostomy was then hooked up to the ventilator. Once confirmed good flow, then the ET tube was removed.
The tracheostomy was secured to patient's neck after hemostasis was completely obtained and confirm.
At the end of the case, counts were carried out. Instrument, sponge, and needle counts were completed and reported to me as correct.
The patient tolerated the procedure