A tracheotomy or a tracheostomy is an opening surgically created through the neck into the trachea (windpipe) to allow direct access to the breathing tube and is commonly done in an operating room under general anesthesia. he resulting stoma (hole), or tracheostomy, can serve independently as an airway or as a site for a tracheostomy tube to be inserted; this tube allows a person to breathe without the use of his or her nose or mouth. The neck is cleaned and draped. Surgical cuts are made to show the tough cartilage rings that form the outer wall of the trachea. The surgeon creates an opening into the trachea and inserts a tracheostomy tube.