inhealth Blom-Singer Instructions For Use Manual page 10

trocar through the posterior tracheoesophageal wall into
the esophagoscope with simultaneous monitoring by the
endoscopist (Diagram 8).
5. Penetration into the esophagus is carefully observed and
immediately terminated when the leading edge of the
white band marker on the needle sheath is observed.
Simultaneously, the color association band on the sheath
where it enters the puncture on the tracheal side of the
tracheoesophageal wall approximates the wall thickness
and appropriate length voice prosthesis to be placed. (White
band 8mm, Blue band 10mm, Orange band 12mm, and
Green band 14mm). (Diagram 2)
6. Use a hemostat to securely stabilize the sheath in the
puncture as the needle is withdrawn.
7. Insert a voice prosthesis of a length corresponding to the
associated sheath color band observed in step 5 into the
lumen of the transparent proximal end of the catheter
such that its esophageal retention flange is forward folded.
(Diagram 9) Insert the strap of the voice prosthesis through
the small window and out the proximal end of the catheter.
Gently pull on the strap while simultaneously deforming
the flanges with your fingers until the voice prosthesis is
positioned inside the catheter as shown in (Diagram 4).
8. Position the inserter stick (included with voice prosthesis)
into the voice prosthesis tracheal end, and attach the strap to
the inserter stick peg (Diagram 10).
9. Thread the distal (narrow) end of the catheter into the sheath
until it is retrieved in the proximal end of the esophagoscope.
10. Firmly grasp the distal (narrow) end of the catheter and with
continuous force pull the catheter through the puncture.
Simultaneously guide and push the voice prosthesis with
the voice prosthesis inserter stick into the puncture until the
tracheal flange and strap rest exactly against the posterior
wall of the trachea. The voice prosthesis will separate from
the catheter. The folded esophageal retention flange will
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