of the gel cap on the tip of the voice prosthesis is inspected to assure that it is securely and fully encapsulating the rear flange a light coating of water or water soluble lubricant oil free is applied to the tip of the gel capped end of the voice prosthesis and the voice prosthesis is immediately inserted fully into the tracheoesophageal puncture by aligning the tip of the voice prosthesis partially in the puncture with the neck strap oriented upwards the prosthesis is held in this position of full insertion for at least 3 minutes this allows time for the gel cap to dissolve and release the retention collar within the esophagus if the prosthesis does not insert easily on the first attempt do not continue to try to insert instead a clean 22 french tracheoesophageal dilator is inserted for a few minutes to dilate the pathway the voice prosthesis strap is detached from the safety peg on the inserter a finger is placed against the strap and the inserter is carefully withdrawn from the prosthesis with a twisting motion a piece of tape is placed over the voice prosthesis strap against the skin the indwelling low pressure voice prosthesis of the invention is designed to permit optional detachment of the strap by a physician or trained speech pathologist following confirmation that the rear flange on the prosthesis is fully opened and securely positioned the rear flange emerges.