We have been using the Groningen voice prosthesis as a method of voice restoration after total laryngectomy for approximately five years. During this period, the Groningen voice prosthesis has been used in 19 patients and a total of 125 unit replacements have been performed. No serious complications have occurred to date. Upon examination of the voice restoration results, exchange frequency, and complications, we noted that 15 out of 19 patients (78.9%) were able to maintain a good voice quality, including cases with long-term observation periods. Voice restoration was difficult in the remaining 4 cases. The overall mean exchange period was 4.5 months, with 2.5 months being the shortest exchange interval in cases without complications. The mean exchange period for cases without complications was 6.1 months. No serious complications, such as a foreign body in the trachea, were encountered. However, several problems with water leakage occurred and were managed appropriately. Aspiration pneumonia from repeated water leakage did not occur, and no cases of TE shunt closure were encountered. These problems may occur with further aging. Thorough follow-ups will be continued in the future.