title: Secondary shunt procedure for alaryngeal patients in an outpatient clinic.
abstract: The shunt procedure used for laryngectomized patients undergoing secondary tracheo-esophageal (T-E) puncture is inconvenient and causes stress to the patient. In order to overcome these problems we developed a novel surgical T-E shunt technique using the Groningen voice prosthesis that does not require esophagoscopy or general anesthesia and can be performed in an outpatient clinic. In this procedure, a shunt is created using a pair of nasal forceps with the patient seated. An endoscope with biopsy forceps is used to insert the Groningen voice prosthesis. The procedure is usually completed within 20 min after inducing local anesthesia. Neither the technique itself nor the time taken to complete the procedure differed for T-E and tracheo-neoesophageal (reconstructed with flap) shunting. We believe that this procedure is suitable for patients who are afraid of esophagoscopy and/or are not considered suitable candidates for esophagoscopy and repeated general anesthesia. The procedure is also beneficial for both patients and surgeons with regard to its duration and the cost-effectiveness of treatment.
authors.affiliation: iwai@takii.kmu.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwai
authors.forename: Hisaya
authors.initials: H
authors.lastname: Yukawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Shinji
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Mari
authors.initials: M
authors.lastname: Adachi
authors.forename: Akiko
authors.initials: A
authors.lastname: Horiguchi
authors.forename: Koichi
authors.initials: K
authors.lastname: Tomoda
authors.forename: Toshio
authors.initials: T
authors.lastname: Yamashita
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000295:instrumentation / Q000379:methods; D000772:Anesthesia, Local; D019723:Endoscopes; D004947:Esophagus / Q000601:surgery*; D006801:Humans; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial; D013517:Otorhinolaryngologic Surgical Procedures / Q000295:instrumentation / Q000379:methods; D014132:Trachea / Q000601:surgery*