Related Experiment Video
Updated: Aug 8, 2026

Learning Modern Laryngeal Surgery in a Dissection Laboratory
Published on: March 18, 2020
Hybrid primary puncture in stapler-assisted total laryngectomy
Jacopo Galli1,2, Luca Perna1, Giorgia Rossi1
1Otorhinolaryngology Unit, Department of Head and Neck, A. Gemelli University Hospital Foundation IRCCS, Rome, Italy.
Abstract:
In Video S1, a new surgical technique for hybrid primary tracheoesophageal (TE) puncture in stapler-assisted total laryngectomy is shown. The video describes the surgical steps of the procedure and illustrates some tips and tricks. The procedure incorporates an upper mini-pharyngotomy to enable retrograde placement of the voice prosthesis (VP), eliminating the need for rigid esophagoscopy. This has made it possible to exploit, without additional risks, the potential of the stapler combined with primary TE puncture and VP placement. In our experience, this hybrid procedure in stapler-assisted total laryngectomy is not related to adverse events such as pharyngocutaneous fistula (PCF), hypertonicity, and functional complications. Therefore, it can be considered a valid technique that allows for easy insertion of a primary voice prosthesis also in case of mechanical sutures.
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