Percutaneous tracheostomy is routinely performed in most intensive care units in the
world.Several studies have shown that the procedure is safe and economically efficient in
comparison to open surgical operation in the operating room.
In our institution as in a number of institutions in the country, it is acceptable to perform
the operation by placing the tube on a high position near the vocal cords by direct
laryngoscopy and then puncturing the trachea with a needle, by location of the anatomy by
palpation of the neck.
Using technological aids, such as direct sonography and bronchoscopy in real time may
significantly reduce the rate of complications as a result of performing percutaneous
So far, no systematic comparison has been made among the three methods.