OBJECTIVETo describe and introduce a new technique for percutaneous dilational tracheostomy without the aid of a bronchoscope.

METHODSTen patients who underwent rotating dilation tracheostomy with percutwist set were prospectively studied. The time needed for the procedure, the grading of the difficulty, the amount of bleeding, and the complications for the procedure were evaluated. All procedures were performed without the aid of a bronchoscope.

RESULTSDuring the operations, blood pressure, ECG parameters were stable. One patient had short period of intraoperative oxygen desaturation. The mean operating time was 6.2 minutes with a range of 3 to 10 minutes. Eight procedures were performed without any difficulty, 2 procedures were performed with some difficulties which could be managed by the surgeon. Six patients had been examined under fibrobronchoscopy within one week postoperatively, no posterior tracheal wall injuries were found. One patient had peristomal bleeding after the operation, one patient had mild infection of the tracheostoma. There were no life threatening complications attributable to this technique.

CONCLUSIONSControlled rotating dilation is a simple, rapid and safe bedside procedure. In the absence of bronchoscopic guidance, the procedure can be safely performed with precautions.