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While few absolute indications exist, this procedure is widely used in patients with upper respiratory obstruction and those requiring long\u2010term mechanical ventilation. The traditional approach to tracheostomy has been an open procedure performed in the operating room. This method is associated with an increased rate of complications and costs. Accordingly, percutaneous bedside tracheostomy procedures have largely replaced the traditional operative approach at many institutions. Numerous methods for percutaneous tracheostomy have thus emerged. However, the benefits of one technique versus another have not been well demonstrated. In this article, we review the evidence supporting the use of percutaneous tracheostomy procedures over the traditional operative approach. Furthermore, we review the currently available and emerging methods by which percutaneous tracheostomy can be performed. In addition, we highlight the available evidence concerning the safety and complication rates of each technique.<\/jats:p>","DOI":"10.1007\/s00268-013-2025-6","type":"journal-article","created":{"date-parts":[[2013,4,9]],"date-time":"2013-04-09T14:28:22Z","timestamp":1365517702000},"page":"1633-1646","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Evolution of Percutaneous Dilatational Tracheostomy\u2014A Review of Current Techniques and Their Pitfalls"],"prefix":"10.1002","volume":"37","author":[{"given":"Jonathan","family":"Cools\u2010Lartigue","sequence":"first","affiliation":[{"name":"LD MacLean Surgical Research Laboratories, Department of Surgery, Montreal General Hospital McGill University 1650 Cedar Avenue, L9\u2010112 H3G 1A4 Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Aboalsaud","sequence":"additional","affiliation":[{"name":"LD MacLean Surgical Research Laboratories, Department of Surgery, Montreal General Hospital McGill University 1650 Cedar Avenue, L9\u2010112 H3G 1A4 Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Gill","sequence":"additional","affiliation":[{"name":"LD MacLean Surgical Research Laboratories, Department of Surgery, Montreal General Hospital McGill University 1650 Cedar Avenue, L9\u2010112 H3G 1A4 Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Ferri","sequence":"additional","affiliation":[{"name":"LD MacLean Surgical Research Laboratories, Department of Surgery, Montreal General Hospital McGill University 1650 Cedar Avenue, L9\u2010112 H3G 1A4 Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4,10]]},"reference":[{"key":"e_1_2_8_2_2","first-page":"749","article-title":"Tracheostomy","volume":"6","author":"Wood DE","year":"1996","journal-title":"Chest Surg Clin N Am"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246\u2010199909000\u201000003"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.6_suppl.477S"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000145232.46143.40"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.05.018"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.12.001"},{"key":"e_1_2_8_8_2","first-page":"488","article-title":"Techniques for performing tracheostomy","volume":"50","author":"Durbin CG","year":"2005","journal-title":"Respir Care"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1955.12.4.0428"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.87.6.715"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000251585.31778.c9"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000163744.89688.E8"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2010.09.024"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei186"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010003\u20101776\u20101"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039\u20106060(05)80279\u2010X"},{"key":"e_1_2_8_17_2","first-page":"543","article-title":"A simple percutaneous tracheostomy technique","volume":"170","author":"Griggs WM","year":"1990","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001340050345"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102044.1991.tb09659.x"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.1054\/jcms.2000.0170"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.5761\/atcs.oa.09.01477"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199911000\u201000014"},{"key":"e_1_2_8_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480206800121"},{"key":"e_1_2_8_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010200103000\u201000021"},{"key":"e_1_2_8_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246\u2010200105000\u201000002"},{"key":"e_1_2_8_26_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1996.01430150043008"},{"key":"e_1_2_8_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc4887"},{"key":"e_1_2_8_28_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.118.5.1412"},{"key":"e_1_2_8_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318093edae"},{"key":"e_1_2_8_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000163401.77581.86"},{"key":"e_1_2_8_31_2","first-page":"113","article-title":"Surgical tracheostomy versus percutaneous dilatational tracheostomy. 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