A device for dilating an opening through the tracheal wall of a patient includes a loading dilator. A balloon catheter is received in the lumen of the dilator such that the balloon extends distal to the loading dilator distal end. The balloon is configured to radially dilate a portion of the tracheal wall upon inflation. The balloon includes retention structure along its outer surface such that upon inflation, the retention structure inhibits dislodgement of the balloon when the balloon is positioned across the tracheal wall. The retention structure may comprise a pair of spaced elements radially projecting from the outer surface of the balloon, and spaced along the outer surface such that each of the elements is disposed at an opposite side of the tracheal wall when the balloon is positioned along the tracheal wall opening.