The more severe grades of long-segment tracheal stenosis or complete tracheal rings are best managed by a surgical procedure called slide tracheoplasty. In this surgery, the narrowed trachea is divided across the middle of the stenosis. The back of the lower tracheal segment is cut and the front of the upper tracheal segment is cut. The opened ends are then slid onto each other and sutured in place to create an airway that is twice as wide and half as long.

The increased width is essential to improving air-flow in an obstructed airway. Sometimes it is necessary to perform the procedure on cardio-pulmonary bypass. The surgery takes anywhere from 1.5 to four hours. The child will have an endotracheal tube (breathing tube) in the immediate post-operative period.