Sassy's tracheotomy surgery at the University of TN Veterinarian School. This was done in July 2006. WARNING GRAPHIC! These photographs were taken during the actual surgery.

Sassy is heavily sedated and put in a device to hold her head up to make her neck accessable. The metal thing with the whole in it that you can see towards the bottom of her neck is her temporary trache that she had about 6 weeks prior to having this surgery. This metal device had to be removed daily and thoroughly cleaned and reinserted. It was removed a few days after this surgery and now is completely closed and healed over. There is still a small knot but that is the evidence that it was ever there.

First they make an incision that goes down the neck about 6-8 inches long and remove all the muscle mass around it. The yellowish color you see in the middle is her actual trachea.

Now the muscle is removed and out of the way they begin to remove part of the trachea. You can see the incision line starting where the surgeon is holding the hemostats.

It is at that point they start removing the front of the trachea and this is where it got so interesting that I stopped taking pictures because I was intent on watching the procedure. The trachea has a cartlidge covering and below that cartlidge is a membrane. They removed 5 rings of the trachea. If you have ever seen the pig trachea dog chews then you will know what I mean when I say a trachea ring. There is a ring every inch or so down the entire trachea. To make it large enough to stay open once it healed it was necessary to take out 5 of them. They start by cutting the cartlidge vertically and carefully taking each side of that incision about an inch to the left and to the right. This piece of the cartlidge is then totally removed for good. Once all the rings were removed they cut through the membrane leaving a wide open hole. The only way I can describe the inside of the trachea is that it looks like the inside of a piece of bamboo if you break open a stalk. Then the final thing they do is suture the skin around the tracheotomy to the inside of the trachea leaving a 'window' for the air flow.

This is the final outcome. The shiny part that can be seen is the inside of her trachea. The sides are sutured and will heal like this. Althought it looks horrible it was the last resort to save Sassy's life. She actually is doing amazingly well and has much better quality of life now.

This is ~ 1 month later and the what the tracheotomy looks like now. It is still healing because several of the sutures came out but it is pretty well healed. The hole is actually hard to see because it is just under her neck so her head and mane cover it a lot.

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