Percutaneous balloon dilational tracheostomy tube

摘要

A method and device 10 for providing an ostomy 102 through the wall 100 of the trachea are particularly advantageous in allowing the ostomy 102 to be formed atraumatically and to be enlarged without risk of perforating the rear of the trachea. The method employs a balloon catheter 16 including an inflatable balloon 18 and entails: positioning the catheter 16 over a percutaneously inserted wire guide 54; advancing the catheter 16 along the wire guide 54 until the balloon 18 lies across the tracheal wall 100; and inflating the balloon 18 to dilate a portion of the tracheal wall 100 and form an ostomy 102. The method desirably includes the further steps of deflating the balloon 18 and inserting a tracheal tube 20 into the ostomy 102. The method is preferably carried out with a device 10 which includes a dilator tube 12 carrying the catheter 16 and tracheal tube 20 on it. Such a construction allows the dilator tube 12, the balloon catheter 16 and the tracheal tube 20 to be advanced on the wire guide 54 together. The tracheal tube 20 can include an inflatable circumferential cuff 24 for providing a seal between the tracheal tube 20 and the tracheal wall 100. The diameter of the balloon 18 preferably is at least equal to, and more preferably slightly greater than, the maximum diameter of the uninflated cuff 24 to be inserted into the ostomy 102. The present invention is also advantageous in that the close dilation or slight over dilation of the ostomy 102 and the taper of the distal end 14 of the dilator tube 12 protect the cuff 24 from damage during insertion of the tracheal tube 20 through the ostomy 102.