A new technique for tracheotomy employs an instrument consisting of three parts: (1) a hollow needle provided with a special slot and lateral opening to serve as a grooved director, (2) a set of cutting blades, one of which is tipped with a ball that can be passed through the lateral opening, advanced along the slot, and passed out of the pointed end of the needle, and (3) the tracheotomy tube, which is thus guided into place and then used as the sheath through which the cutting blades are withdrawn. The technique is simple and rapid when used in adult patients free from displacement or deformity of the trachea.
Shelden CH, Pudenz RH, Tichy FY. PERCUTANEOUS TRACHEOTOMY. JAMA. 1957;165(16):2068–2070. doi:10.1001/jama.1957.02980340034009