A tracheostomy is a specialized surgical procedure that creates a direct airway opening through the neck into the trachea (windpipe). This essential procedure effectively establishes a stable airway for patients requiring long-term ventilation, those with upper airway obstruction, or individuals needing pulmonary secretion management.We understand that procedures involving your breathing can be particularly concerning for both patients and families. That's why we're committed to providing compassionate, expert care while helping you understand each step of your treatment plan. We perform tracheostomies using minimally invasive techniques whenever appropriate, with custom stoma sizing and specialized tracheostomy tube selection based on individual anatomy and clinical needs, resulting in improved comfort, reduced complications, and a focus on maintaining voice function whenever medically possible.
You may need a tracheostomy if you experience:
Upper airway obstruction from trauma, tumors, or other structural abnormalities
Need for prolonged mechanical ventilation (typically exceeding 7-10 days)
Severe sleep apnea unresponsive to other treatments
Inability to protect the airway due to neurological conditions
Bilateral vocal cord paralysis causing breathing difficulties
Severe facial or neck trauma affecting the airway
Congenital abnormalities affecting breathing
Need for improved pulmonary hygiene and secretion clearance
Preparation for certain head and neck surgeries
Respiratory failure requiring ventilator support
Chronic aspiration with recurrent pneumonia
Severe burns or smoke inhalation affecting the airway
Our approach to tracheostomy combines precision with personalized care. The procedure begins with a thorough evaluation to determine the most appropriate technique—either open surgical or percutaneous dilatational tracheostomy—based on your specific anatomical and clinical considerations. Our surgeon's expertise in using ultrasound guidance for enhanced precision, particularly in identifying vascular structures to minimize bleeding complications is our focus. We specialize in customized tracheostomy management, including the selection of the optimal tube type and size for each patient's unique anatomy and breathing needs. Our multidisciplinary approach integrates respiratory therapists, speech pathologists, and nursing specialists into your care team, ensuring comprehensive training for both patients and caregivers. We place particular emphasis on preserving voice capability when medically feasible through specialized speaking valves and custom tube adaptations, maintaining quality of life alongside essential respiratory support.
Immediate Post-Procedure (24-72 hours)
Expect specialized nursing care in an ICU or step-down unit initially
Humidified air will be provided through the tracheostomy to prevent drying
Regular suctioning will be performed to keep the airway clear
Communicate using writing, gestures, or communication boards until speaking options are established
The surgical site will be monitored closely for bleeding or signs of infection
Tracheostomy care education will begin for you and your caregivers
Pain management will be provided as needed (discomfort is typically minimal)
Respiratory therapy will monitor your breathing parameters
Nutrition will be maintained either orally or through alternative means, depending on your condition
Short-Term Recovery (1-3 weeks)
The initial tube will typically be changed to a long-term tube after 5-7 days
Tracheostomy care training continues, including cleaning techniques and emergency measures
Speaking options will be evaluated, potentially including speaking valves for appropriate candidates
Activity levels increase gradually as comfort and stability allow
Wound care around the stoma site becomes routine
Humidity needs to continue with either heat-moisture exchangers or humidifiers
Swallowing assessment and therapy may begin if relevant
Transition to home care planning begins if the tracheostomy will be long-term
Equipment needs are assessed and arranged for home management
Follow-up appointments are scheduled for tube changes and site assessment
Long-Term Expectations
The tracheostomy site typically matures within 3-4 weeks, forming a stable stoma
Regular tube changes become routine (typically every 4-8 weeks depending on the type)
Many patients adapt well to communication strategies, including speaking valves when appropriate
Improved respiratory status with easier breathing and secretion management
Individualized follow-up schedule based on your specific needs and condition
For temporary tracheostomies, evaluation for decannulation (removal) begins when medically appropriate
After successful decannulation, the stoma typically closes naturally within 1-2 weeks
Regular reassessment of tube size and type ensures optimal function as your condition evolves
Most patients and caregivers become proficient in routine tracheostomy care
Quality of life improvements through stabilized breathing and reduced respiratory distress
Common Side Effects
Formation of granulation tissue around the stoma site
Increased mucus production, especially initially
Mild discomfort or pressure sensation around the tracheostomy
Temporary voice changes or inability to speak with standard tubes
Cosmetic changes with a visible stoma and potential for minor scarring
Need for ongoing care and maintenance of the tracheostomy site
Changes in normal humidification of inspired air
Less Common Complications
Bleeding from the insertion site or surrounding structures
Subcutaneous emphysema (air trapped under the skin)
Tracheal stenosis (narrowing of the trachea)
Tube displacement or accidental decannulation
Tracheomalacia (weakening of the tracheal walls)
Tracheoesophageal fistula (abnormal connection between trachea and esophagus)
Infection at the stoma site or developing pneumonia
Tracheo-innominate artery fistula (rare but serious vascular complication)
Damage to surrounding structures during placement
When to Seek Immediate Medical Attention
Difficulty breathing or respiratory distress
Tube becoming dislodged or falling out completely
Significant bleeding from the tracheostomy site
Inability to pass a suction catheter through the tube
Signs of infection (increased redness, warmth, pus, or fever)
Subcutaneous emphysema (air under the skin causing swelling or crackling sensation)
Persistent coughing or choking episodes
Chest pain or sudden decline in oxygen levels
Complete obstruction of the tube with secretions that cannot be cleared
From your first consultation through your complete recovery, we provide:
Thorough evaluation and explanation of your condition
Clear discussion of all treatment options, including non-surgical alternatives when appropriate
Detailed pre-operative instructions to help you prepare
Compassionate care during your hospital stay or outpatient procedure
Comprehensive follow-up care and support during recovery
Ongoing availability to address questions or concerns
We understand that facing head and neck surgery can be intimidating, but you don't have to navigate this journey alone. Our team is committed to providing expert care with a personal touch, ensuring you feel supported, informed, and confident every step of the way.
Your health and wellbeing are our highest priorities, and we're honored to be part of your care team.
.svg)
All our laparoscopic procedures are performed by our highly trained surgical team using state-of-the-art equipment and techniques.
We're committed to providing you with the most advanced, minimally invasive options because we believe you deserve:
Less pain after surgery
Shorter hospital stays
Faster return to work and activities you enjoy
Smaller, less visible scars
Lower risk of complications
Better overall outcomes
Dr. Richard Nguyen is a board-certified General Surgeon with over 20 years of surgical expertise and fellowship training in Minimally Invasive and Bariatric Surgery from Vanderbilt University. Since establishing his practice in San Jose in 2007, he has pioneered innovative surgical techniques, including single-incision laparoscopic procedures and mastery of the da Vinci Robotic Surgical System. Beyond his acclaimed bariatric surgery practice, he has earned national recognition for his specialized expertise in both non-mesh and advanced mesh hernia repairs, while also serving as a critical approach surgeon for anterior spine access procedures. Dr. Nguyen combines technical precision with personalized care across multiple premier facilities throughout the South Bay Area.
I would refer Doctor Nguyen to anyone, in fact I have and they have all had the same experience as me. He is truly great. I owe all my success to Doctor Nguyen and I thank him for all the work he has done for me and continues to do so. He is extremely amazing, and I am very grateful to him.
.avif){kind=avatar}
At 50, I now have a life I had only dreamed of a year before. My body tells me if I am done eating. This surgery is a tool that I have used to the fullest. It is not an easy way out. It still took work. But I honestly know that I would not be living this amazing new life if I didn’t step forward to embrace this life-saving surgery.
.avif){kind=avatar}
Dr. Nguyen has changed my life completely. I feel so much better and I also feel like I’ve got control of my life again…I had high blood pressure, diabetes and cholesterol. I took at least 5 different medications for the past 30 years. NOW, after surgery I take no medications only vitamins!
Wondering which surgical procedure might be right for your condition? We're here to help you understand your treatment options and develop a personalized surgical plan. Contact our office today to schedule a consultation.
Your path to improved health may be more achievable than you think—with advanced surgical techniques leading to faster recovery, reduced complications, and a significantly enhanced quality of life.