Bloodless Tonsil Removal Surgery

We Performed Tonsillectomy Operation With Thermal Welding Method in Patient with Obstructive Sleep Apnea Syndrome and Tonsil Stone (Magma) 

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Tonsils are formed by the accumulation of dead cells, inflammation and food debris on recessed pit areas ("crypt" areas) on the surface of the tonsils, and stone formation is easier in the tonsils with rough, recessed protrusions. The main symptom in patients with tonsils is usually mouth odor. In fact, the cause of bad breath is competing with "reflux" among the reasons (see Turkish article "Bademcik Taşı Temizliği" ni Garantili Ağız Kokusu Tedavi Yöntemi Olarak Görmeyin!").

Depending on the tonsils or magma, there may be a foreign body feeling in the throat, pain rarely in the ear, and a feeling of hanging while swallowing. The fact that there are no stones on the tonsils does not mean that there are no stones in the tonsils. When the tonsils are squeezed out during the operation, when the tonsils are pressed from the deep pit areas, tonsil stones can be seen. Simple surface cleaning is not sufficient for treatment. There is no known permanent medical treatment. As a result, when the food passes mechanically through the throat, the edges fill sharp and deep pit areas and new stone formation begins. The most effective treatment is the removal of tonsils. In this method, called "laser cryptolysis", which can be described as "smoothing the surface of the tonsils" (my father carpenter and perhaps my first work "sanding" the surface of the tonsils according to carpentry) in order to make the sharp and deep upper areas of the laser pit areas more superficial and smoother, It is aimed to prevent further rubbing of the surface and escape into the pit. Of course, it is not a permanent and fully effective method because I do not prefer deep cavities or the bottom of the pits because of the mucosal burn injury that the laser has given ... In the above photo, you can see the tonsils that have just started to form under the left tongue.

As the size of the tonsils increases, the massive effect narrows the cross-sectional area of ​​the airway in the throat and is associated with sleep apnea syndrome, especially when lying down on the back, such as lying on the back, side lying, tired waking, sleepy breathing, sleeping after lunch, sweating at night, can cause the indication. It is not the patient's tired awakening or sweating; the risk of cardiovascular diseases can be increased by many different mechanisms, such as hypertension elevations caused by decreased blood oxygen levels during sleep, and secretion of anti-insulin stress hormones in those with large tonsils.

Perhaps the slogans about the "Bloodless, knifeless, painless tonsillectomy - bloodless, knifeless painless tonsillectomy - Thermal welding tonsillectomy", which has become popular in recent years as the best method of tonsillectomy, is emphasized to be a bit exaggerated. It would be more accurate to call it "bloodless" or "much more bloodless" for the slogan "more bloodless tonsil surgery" because there is almost no blood from the surgery at the time of surgery, but in adults and patients who have had tonsilitis beforehand, the tonsil capsule may be more adherent, A few drops of blood can be seen in patients with excessive vasculature. It would be more accurate to say that it is "quite painless" instead of the "painless tonsil operation" slogan, or that it "significantly reduces post-operative pain." Imagine that with a fine needle, you can feel pain in the area of ​​the needle application for 1 week if you are a needle from the shoulder or hindquarters. According to "thermal welding and tonsil operation" which is a method that significantly reduces the risk of heat dissipation and heat damage to the tissue outside the tonsil tissue compared to other methods, if the burner and the stopping mode of the device are not used during the procedure, a considerable difference is created in terms of postoperative pain. Nevertheless, "painless" is a bit exaggerated, but when used correctly, pain is much less with thrmal welding device than with other methods after tonsillectomy. The slogan "without knife" is accurate and the probe of the thermal welding device is sufficient for the complete removal of the tonsils and no additional metal is needed to cut or remove the tonsils.

We performed tonsillectomy with a thermal welding device in our patient who had both tonsils and signs of sleep apnea. You can find images before and after the above and below photos. I generally prefer not to sew with the suture materials that melt the pledgets between the front and the back of the tonsils and inject the local anesthetic into the area where the tonsils are taken. If you enlarge photos, you can see small pinholes and purple stitches that do not have charring due to heat damage.

Thermal welding tonsillectomy - Tonsillectomy in Istanbul - Tonsil removal in Istanbul - Bloodless, knifeless, painless tonsillectomy in Istanbul - Treatment of big tonsils

Thermal welding tonsillectomy - Tonsillectomy in Istanbul - Tonsil removal in Istanbul - Bloodless, knifeless, painless tonsillectomy in Istanbul - Treatment of big tonsils

Tonsillectomy, the surgical removal of the tonsils, is a well-known procedure performed to address various medical conditions, primarily chronic tonsillitis, and obstructive sleep apnea syndrome (OSAS). Traditionally, tonsillectomy has been executed using methods such as cold knife dissection or electrocautery, both of which have their advantages and drawbacks. However, a relatively newer technique called "tonsillectomy with thermal welding" has gained recognition as a modern approach to this surgery. In this article, we delve into the details of this innovative method, its benefits, and how it's transforming tonsillectomy surgery.

Understanding Tonsillectomy

Tonsils, two small masses of lymphoid tissue located at the back of the throat, play a role in the body's immune system by helping to filter out potentially harmful bacteria and viruses. However, in some cases, the tonsils themselves can become a source of health issues. Common conditions that may necessitate tonsillectomy include:

Recurrent Tonsillitis: Frequent and severe bouts of tonsillitis that don't respond well to other treatments may require surgical removal of the tonsils.

Obstructive Sleep Apnea Syndrome (OSAS): Enlarged tonsils can obstruct the airway, leading to sleep disturbances and breathing difficulties.

Tonsil Stones (Tonsilloliths): The tonsils can develop small, hard, calcified formations known as tonsil stones, which can cause discomfort and bad breath.

Traditional Tonsillectomy Methods

Traditionally, tonsillectomy has been performed using methods that involve dissecting or removing the tonsils with cutting instruments or electrocautery. Two common techniques are:

Cold Knife Dissection: This method involves using a scalpel to cut away the tonsils. It is a precise but relatively invasive technique that can lead to post-operative pain and a longer recovery period.

Electrocautery: Electrocautery uses an electrical current to cut and cauterize the tonsil tissue simultaneously. While it can help control bleeding, it can also result in longer recovery times and discomfort.

While these traditional methods are effective, they may be associated with more post-operative pain and a somewhat extended recovery period. This has led to the exploration of alternative tonsillectomy techniques that are less invasive and offer quicker recovery times.

Tonsillectomy With Thermal Welding

Tonsillectomy with thermal welding is a relatively newer technique that aims to address some of the limitations of traditional methods. This innovative approach utilizes thermal energy to remove the tonsils while simultaneously sealing blood vessels, reducing the risk of bleeding, and potentially leading to a quicker and less painful recovery. Here's how the procedure works:

Anesthesia: Before the surgery begins, the patient is placed under general anesthesia to ensure they remain comfortable and unconscious throughout the procedure.

Laser or Radiofrequency Ablation: The tonsil tissue is then treated with either laser or radiofrequency energy, which generates heat. This heat effectively removes the tonsils while sealing blood vessels to minimize bleeding.

Removal of Tonsils: As the thermal energy is applied, the tonsils are gently and precisely removed.

Post-Operative Care: Once the tonsils have been successfully removed, the patient is closely monitored as they wake from anesthesia. They are typically allowed to return home the same day.

Benefits of Tonsillectomy With Thermal Welding

The use of thermal welding in tonsillectomy has several advantages, making it an attractive option for both patients and surgeons:

Minimized Bleeding: The thermal welding method effectively seals blood vessels during the procedure, reducing the risk of post-operative bleeding, a common concern with traditional techniques.

Faster Recovery: Patients often experience a quicker and less painful recovery compared to traditional tonsillectomy methods. This allows them to return to their normal routines sooner.

Reduced Post-Operative Pain: The thermal welding method tends to be associated with less post-operative pain, which can be a significant relief for patients, especially children.

Precision and Accuracy: The use of thermal energy allows for precise and controlled removal of the tonsils, reducing the risk of damage to surrounding tissues.

Lower Risk of Infection: The reduced risk of bleeding, along with the cauterization effect of thermal welding, can lead to a lower risk of infection.

Since thermal welding is less invasive, it can result in a neater appearance post-surgery, which can be important for some patients.

Considerations and Preparing for Surgery

Before undergoing tonsillectomy with thermal welding, it's crucial to consider the following:

Consultation: Schedule a consultation with an experienced ENT (ear, nose, and throat) specialist or surgeon to discuss your specific condition and determine if this technique is suitable for you.

Medical Evaluation: Your surgeon will conduct a thorough medical evaluation to ensure you are a suitable candidate for the procedure.

Pre-Operative Instructions: Your surgeon will provide you with pre-operative instructions, which may include fasting before the surgery and discontinuing certain medications.

Post-Operative Care: Understand and prepare for the post-operative care and recovery process, which may include a modified diet and pain management.

Recovery and Post-Operative Care

Recovery from tonsillectomy with thermal welding is often quicker and less painful than recovery from traditional tonsillectomy methods. However, there are still some post-operative considerations to keep in mind:

Pain Management: Some discomfort and soreness may still be experienced after the procedure. Your surgeon will provide pain management instructions and medications to help alleviate any discomfort.

Diet Modification: Patients are typically advised to follow a soft diet for a period after the surgery to avoid irritating the surgical site. Cold, soft foods like yogurt, applesauce, and ice cream can be soothing. Consuming hard, hot, spicy, excessively salty and sour foods should be avoided.

Hydration: Staying hydrated is essential for the healing process. Drinking plenty of fluids can help reduce the risk of complications.

Follow-Up Appointments: It's important to attend all follow-up appointments with your surgeon to monitor your progress and address any concerns or questions.

The Future of Tonsillectomy

Tonsillectomy with thermal welding represents a significant advancement in the field of tonsil surgery. It offers a less invasive, more efficient, and potentially less painful option for patients with conditions that require tonsil removal. As technology continues to evolve, it is likely that further innovations and improvements will emerge, ultimately benefiting patients who require tonsillectomy.

Tonsillectomy with thermal welding is a modern approach to a common procedure, offering several advantages over traditional methods, including minimized bleeding, faster recovery, reduced post-operative pain, and improved cosmetic outcomes. It provides a promising option for individuals with chronic tonsillitis, obstructive sleep apnea syndrome (OSAS), tonsil stones, and other conditions that necessitate tonsil removal. As with any surgical procedure, it's essential to consult with a qualified healthcare professional to determine the most suitable approach for your specific case. The future of tonsil surgery is bright, with innovative techniques like thermal welding leading the way toward better patient outcomes and enhanced quality of life

Link group where you can read the articles I published about tonsillectomy on this website >>

Videos that I have already published about the tonsillectomy operation >>

Bloodless Tonsillectomy - Thermal Welding Tonsillectomy Video:

Bloodless, Bladeless and Much More Painless Tonsillectomy Technique: Thermal Welding Method Video:

Bladeless and Bloodless Tonsillectomy Method - Thermal Welding Technique:

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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