Tracheotracheal resection anastomosis
by Philippe Vicky S, Philippe Bachi T, Philippe Monnier Menon

Jaypee’s Video Atlas of Operative Otorhinolaryngology AND Head & Neck Surgery

by Vicky S Khattar, Bachi T Hathiram
About Video

Here the surgical technique of tracheotracheal resection anastomosis for a tracheal stenosis has been demonstrated in an easy stepwise manner. It is usually performed for patients of complete tracheal stenosis or for stenosis extending to the posterior membraneous trachea or where the cartilaginous framework support is lost (cases where endoscopic dilatation will not yield fruitful results). The video outlines the basic aspects of tracheal anatomy as well as the principles of resection and anastomosis that will ensure a successful outcome. Certain aspects of the technique have been highlighted here. During mobilization of the tracheal stumps, one must dissect as close to the cartilaginous framework as possible, to stay away from the recurrent laryngeal nerves. Secondly, the blood supply of the trachea which comes from the lateral aspects should be identified and preserved as far as possible. The use of sharp dissection and bipolar cautery can reduce the damage to the cartilaginous framework, thus preventing devitalization of the cartilages, and ensuring a successful outcome. For the anastomosis, the posterolateral aspects of the tracheal cartilages should be sutured first, followed by the posterior membranous trachea, and finally the anterior cartilaginous rings. Mobilization of the tracheal stumps may be performed from inferior and superior aspects, depending upon the site of the stenosis.

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