Fig. 1

Schema of the double gum elastic bougie technique. a The tracheal stent was exposed when the tracheal window was opened at the inferior border of the cricoid cartilage. b A gum elastic bougie was passed into the orally intubated tube, and the intubation tube was pulled to enable extraction of the tracheal stent from the tracheostomy. The cranial end of the tracheal stent was pulled out through the tracheal opening window. Another gum elastic bougie was passed through the tracheal stent lumen and advanced to the tracheal bifurcation. c The tracheal stent was removed while maintaining a secure airway through the orally intubated tube and the tracheal opening using two gum elastic bougies. d After removal of the tracheal stent, a tracheostomy tube was inserted through the gum elastic bougie