Anterograde replacement is difficult due to a small stoma
Problem: due to a small stoma anterograde replacement is difficult
In experienced hands the replacement procedure is quick enough to allow a short blockage of the stoma without ‘choking’ the patient. Also, if the diameter of the stoma is so small that the loading tube is completely obstructing it, the patient probably should wear a trachea cannula, like the LaryTube or Lary Button, anyway. This should dilate the stoma well enough to allow replacement of the prosthesis. Otherwise a stoma plasty could be indicated. Another option is to use the traditional retrograde replacement method with the guide wire.
In experienced hands the replacement procedure is quick enough to allow a short blockage of the stoma without ‘choking’ the patient. Also, if the diameter of the stoma is so small that the loading tube is completely obstructing it, the patient probably should wear a trachea cannula, like the LaryTube or Lary Button, anyway. This should dilate the stoma well enough to allow replacement of the prosthesis. Otherwise a stoma plasty could be indicated. Another option is to use the traditional retrograde replacement method with the guide wire.