Safe Percutaneous Dilatational Tracheostomy Using a Pre‐Measured Light‐Guided Endotracheal Tube Withdrawal Technique: A Case Report

ABSTRACT Percutaneous dilatational tracheostomy (PDT) is a bedside procedure for patients requiring prolonged mechanical ventilation. Although its overall safety is comparable to that of surgical tracheostomy, complications related to endotracheal tube (ETT) manipulation remain a concern. In this report, we describe a simple, reproducible two‐step approach for ETT repositioning during PDT that (1) pre‐measures an individualized withdrawal distance using bronchoscopic illumination and (2) confirms final positioning in real time by transillumination at the incision site in a patient requiring tracheostomy after prolonged mechanical ventilation. The procedure was completed within 20 min without complications. This technique may facilitate safer ETT repositioning during PDT.