In the method described by Ciaglia et al., the trachea is cannulated transcutaneously below the cricoid cartilage under bronchoscopic observation. For this purpose, a Seldinger wire with seven graduated dilatators is used for successive tracheal dilatation to 36 CH and insertion of an indwelling tracheal cannula. The disadvantage of this procedure is the time-consuming successive insertion of seven bougies and the repeated risk of injury to the dorsal tracheal wall. Percutaneous cannulization sets are expensive and cannot be re-sterilized. We developed a re-sterilizable, single-step bougienage device and tested the procedure successfully without any complications in 74 patients.