Reviewed by Cheryl Torres, RRT, Michael D. Schwartz, MD, FCCM

What are the phases of TTOT Care?

Phase 1 – Patient Screening

During this phase, you will have an opportunity to learn about the benefits and risks associated with TTOT. The doctors, nurses, respiratory therapists and perhaps other people who have gone through the TTOT procedure will be available to answer your questions. Your provider will perform a physical exam, take your medical history and determine whether you are a good candidate to receive TTOT. Education will be provided by your respiratory therapist following your doctor visit.


Phase 2 – The TTOT Procedure

If your doctor feels you are a good candidate, a consult will be scheduled with the performing surgeon, who will then schedule the procedure. The Fast Track procedure requires an overnight stay. The procedure uses a stent to create the hole for the catheter. The next morning, the stent is removed and the catheter is put in place.


Phase 3 – Care while the TTOT Tract Is Healing

Once the catheter has been placed, proper care is very important. You will clean the catheter in place at home and will come to the respiratory care department twice a week for postoperative care. The therapist will inspect the site and change the catheter for you until you are ready to take on self-care.


Phase 4 – Care when the TTOT Tract Has Healed, Graduation Day!!!

You are ready and capable of self-care. This is when the Respiratory Care Team transfers responsibility over to you. Changing the catheter is recommended twice a day. New catheters are supplied for you by your DME (durable medical equipment) service every 90 days.


This information was approved by Michael D. Schwartz, MD, and Cheryl Torres, RRT, (September 2017)