Skip to main content Accessibility help

PercuTwist: a new alternative to Griggs and Ciaglia’s techniques

  • N. Yurtseven (a1), B. Aydemir (a2), P. Karaca (a3), T. Aksoy (a4), G. Komurcu (a5), M. Kurt (a1), V. Ozkul (a1) and S. Canik (a1)...


Background and objective

Tracheostomy is one of the most common procedures in intensive care units worldwide. In this study we aimed to compare three different tracheostomy techniques with respect to duration of procedure and complications.


One hundred and thirty patients requiring endotracheal intubation for more than 10 days due to acute respiratory distress syndrome, infections or cerebrovascular events were consecutively selected to undergo the percutaneous dilatational tracheostomy technique (PDT n = 44), the guide-wire dilating forceps technique group (GWDF n = 41) or the PercuTwist technique (n = 45). The time taken to perform the procedure (skin incision to successful placement of tracheostomy tube) and complications were recorded.


The operating times were found to be 9.9 ± 1.1, 6.2 ±1.4 and 5.4 ± 1.2 min in PDT, GWDF and PercuTwist groups, respectively. The duration of the procedure was significantly shorter in the PercuTwist group as compared to the percutaneous dilatational tracheostomy (P < 0.01) and guide-wire dilating forceps (P < 0.05) groups. During postoperative bronchoscopy, eight cases of longitudinal tracheal abrasion (four in the PDT group, two in the GWDF group and two in the PercuTwist group), two cases of posterior tracheal wall injury (one in PDT and one in GWDF) and one case of tracheal ring rupture in the PDT group were seen.


Percutaneous tracheostomy techniques have their own advantages and complications. PercuTwist, a new controlled rotating dilatation method, was associated with minimal complications, appears to be easy to perform and a practical alternative to percutaneous dilatational tracheostomy and guide-wire dilating forceps techniques.


Corresponding author

Correspondence to: Dr Tamer Aksoy, Department of Anesthesia and Reanimation, Maltepe Universitesi Tip Fak., Ataturk Cad, Cam Sok. No 3 Maltepe, Istanbul 34170, Turkey. E-mail:; Tel: +90 216 399 9750; Fax: +90 216 370 9719


Hide All
1.Jackson, C. Tracheostomy. Laryngoscope 1909; 19: 285290.
2.Shelden, CH, Pudenz, RH, Tichy, FY. Percutaneous tracheostomy. JAMA 1957; 165: 20682070.
3.Ciaglia, P, Firsching, R, Syniec, C. Elective percutaneous dilatational tracheostomy: a new simple bedside procedure: preliminary report. Chest 1985; 87: 715719.
4.Griggs, WM, Worthley, LIG, Gilligan, JE, Thomas, PD, Myburg, JA. A simple percutaneous tracheostomy technique. Surg Gynecol Obstet 1990; 170: 543545.
5.Frova, G, Quintel, M. A new simple method for percutaneous tracheostomy: controlled rotating dilation. Int Care Med 2002; 28: 299303.
6.Johnson, JL, Cheatham, ML, Sagraves, SG, Block, EF, Nelson, LD. Percutaneous dilational tracheostomy: a comparison of single-versus multiple-dilator techniques. Crit Care Med 2001; 29: 12511254.
7.Westphal, K, Maeser, D, Gert, S et al. . PercuTwist: a new single-dilator technique for percutaneous tracheostomy. Anesth Analg 2003; 96: 229232.
8.Fikkers, BG, Staatsen, M, Lardenoije, S et al. . Comparison of two percutaneous tracheostomy techniques: guide wire dilating forceps and Ciaglia blue rhino: a sequential cohort study. Crit Care 2004; 8: 299305.
9.Chendrasekhar, A, Ponnapalli, S, Duncan, A. Percutaneous dilational tracheostomy: an alternative approach to surgical tracheostomy. South Med J 1995; 88: 10621064.
10.Bradley, D, Isabella, K, Lin, N et al. . A meta-analysis of prospective trials comparing percutaneous and surgical tracheostomy in critically ill patients. Chest 2000; 118: 14121418.
11.Friedman, Y, Fildes, J, Mizock, B et al. . Comparison of percutaneous and surgical tracheostomies. Chest 1996; 110: 480485.
12.Bodenham, AR. Percutaneous dilatational tracheostomy, completing the anaesthetists range of airway techniques. Anaesthesia 1993; 48: 101102.
13.Cobean, R, Beals, M, Moss, C, Bredebberg, C. Percutaneous dilatational tracheostomy: a safe, cost-effective bedside procedure. Arc Surg 1996; 131: 265271.
14Nates, JL, Cooper, J, Myles, PS et al. . Percutaneous tracheostomy in critically ill patients: a prospective, randomized comparison of two techniques. Crit Care Med 2000; 28: 37343739.
15.Byhahn, C, Wilke, HJ, Lischke, V et al. . Bedside percutaneous tracheostomy: clinical comparison of Griggs and Fantoni techniques. World J Surg 2001; 25: 296301.
16.Byhahn, C, Wilke, HJ, Halbig, S et al. . Percutaneous tracheostomy: Ciaglia Blue Rhino versus the basic Ciaglia technique of percutaneous dilational tracheostomy. Anesth Analg 2000; 91: 882886.
17.Bewsher, MS, Adams, AM, Clarke, CW et al. . Evaluation of a new percutaneous dilatatioal tracheostomy set apparatus. Anaesthesia 2001; 56: 859.
18.Sengupta, N, Ang, KL, Prakash, D et al. . Twenty months routine use of a new percutaneous tracheostomy set using controlled rotating dilatation. Anesth Analg 2004; 99: 188192.
19.Roberts, RG, Morgan, P, Findlay, GP. Percutaneous dilatational tracheostomy and tracheal ring rupture. Anaesthesia 2002; 57: 933934.
20.Scherrer, E. Tracheal ring fracture during a PercuTwist tracheostomy procedure. Anesth Analg 2004; 98: 14511453.
21.Anon, JM, Gomez, V, Escuela, MP et al. . Percutaneous tracheostomy: comparison of Ciaglia and Griggs techniques. Crit Care 2000; 4: 124128.
22.Van Heurn, LW, Mastboom, WB, Scheeren, CL et al. . Comparative clinical trial of progressive dilatational tracheostomy. Intens Care Med 2001; 27: 292295.


PercuTwist: a new alternative to Griggs and Ciaglia’s techniques

  • N. Yurtseven (a1), B. Aydemir (a2), P. Karaca (a3), T. Aksoy (a4), G. Komurcu (a5), M. Kurt (a1), V. Ozkul (a1) and S. Canik (a1)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed