title: Primary tracheoesophageal puncture in stapler-assisted total laryngectomy.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pa., USA. kevin.leahy @ uphs.upenn.edu
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Leahy
authors.forename: Ralph P
authors.initials: RP
authors.lastname: Tufano
mesh_terms: D019723:Endoscopes; D004724:Endoscopy / Q000379:methods; D004945:Esophagoscopy; D004947:Esophagus / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000295:instrumentation* / Q000379:methods*; D007828:Laryngoscopy; D011183:Postoperative Complications / Q000517:prevention & control; D017792:Surgical Stapling; D014132:Trachea / Q000601:surgery