and safe surgical procedure and technology.

A tracheotomy is a temporary or permanent treatment for a variety of causes of breathing difficulties in which the creation of a new breathing pathway is required, by-passing the nose, mouth, and throat. Tracheotomy is one of the most frequent surgical procedures carried out in critically ill patients and the overall trend is that Percutaneous Tracheotomy is becoming more frequently used. Traditionally, open surgical tracheotomy has been done by surgeons in the operating room, and in many institutions it remains that way. The percutaneous technique has eliminated drawbacks that an open tracheotomy involves, including the need of an operation theatre and staff intensive effort, and that it leaves an open wound that can become an infection site. Furthermore, it also puts heavy demands on surgical skill training. Moreover, the open technique is burdened with the risk of surgical complications.