Shunt creation during laryngectomy by an incision over an anatomical clamp

The simplest form of shunt ceration during laryngectomy without special instruments is through a horizontal incision over a small anatomical clamp.

The clamp (1) is pushed into the esophagus through the opened pharynx. The tip of the clamp is visible on the Pars membranaca, so it is easy to select the point of incision. The incision should be made horizontally to prevent the Pars membranaca of the trachea from tearing vertically.

The clamp is guided into the trachea through the incision (2) and a guidewire drawn through the incision for the placement of a voice prosthesis or stomach tube as a spacer.