Abstract: A surgical procedure for creating a saucerized tract for insertion of a transtracheal catheter allows early institution of transtracheal oxygen therapy, facilitates rapid tract maturation, and reduces the incidence of post-operative complications. A vertical incision is made through the skin and subcutaneous tissue at the midline of the patient's neck overlying the trachea, and the sternothyroid muscle is dissected apart to expose the trachea. Local advancement flaps, preferably consisting of full-thickness skin, are elevated on either side of the incision, and subcutaneous fat is removed from beneath the incision and flaps. The flaps are then tunneled toward the trachea and sutured to the undersides of the separated sternothyroid muscle to form a saucerized region. An opening is created through the trachea within the saucerized region and a temporary stent is inserted. After a brief initial healing period of about one day, the stent can be removed and replaced with a transtracheal catheter.