Primary tracheoesophageal puncture in stapler-assisted total laryngectomy

Background/Aims: The purpose of this article was to present a novel technique for primary tracheoesophageal puncture (TEP) in patients undergoing stapler-assisted laryngectomy. Methods: A case series of 10 consecutive patients treated with stapler-assisted laryngectomy that underwent primary TEP at the time of the initial surgery was conducted. The technique involves the use of a flexible esophagoscope and a modified Seldinger technique to safely create the TEP under direct visualization without disrupting the stapler closure. This series was performed at a single academic institution. The primary outcome measured was ability of alaryngeal speech. Results: A total of 10 consecutive patients had the procedure done. All patients achieved alaryngeal speech and there were no complications. Conclusion: This method allows for a safe and efficient TEP creation at the time of stapler-assisted laryngectomy, obviating the need for secondary procedures, either in the office or operating room.