Tonsillectomy Techniques

Tonsil Removal Surgery Techniques

Techniques of Tonsillectomy Operation

Tonsil surgery was first performed by the Roman surgeon Celsus and described a technique of tearing, pulling with hook and cutting with scalpel.

Today, many tonsillectomy techniques have been described and many surgeons can still use scalpel during tonsillectomy. Tonsil surgery techniques can be listed as follows:

Cold knife technology

Removal of tonsils using a scalpel. This technique is applied especially in young patients and under general anesthesia conditions. Although postoperative recovery is rapid, the risk of bleeding may be high.

Electrocautery-assisted tonsillectomy

Electrocautery separates the tonsil tissue from the external tissue. This technique causes less blood loss than the cold knife technique. This may cause thermal damage to the tissue outside the tonsils. Postoperative pain may also be high due to heat damage.

Harmonic scalpel technique

This medical device is in the form of a blade with 55,000 vibrations of ultrasonic energy per second. Knife vibration is not seen with bare eyes. The vibration energy cuts the tissue and at the same time allows the bleeding to be stopped (coagulation).

Radiofrequency ablation (somnoplasty)

By using monopolar radiofrequency, tonsil tissue can be reduced under local anesthesia and office conditions. There are contradictory views that there may be pain and small abscess areas in tonsil area.

Tonsil reduction with laser (laser tonsil ablation)

A carbon dioxide laser or KTP laser can be used to vaporize and shrink tonsil tissue. This procedure is recommended for respiratory recurrence caused by chronic recurrent tonsillitis, chronic sore throat, severe halitosis or enlarged tonsils. When laser-induced mucosal burns, severe pain can be seen.

Microdebrider assisted tonsil reduction

A microdebrider is a medical device with a rotating and vacuuming tip. Tonsil tissue can be shaved with endoscopic method and microdebrider. There is a risk of post-operative hemorrhage, as the severed tonsils are left behind.

Coblation method

The coblation device creates an ionized saline layer that disrupts molecular bonds without the use of heat. This mechanism can be used to remove all or only a portion of the tonsils. Less pain after surgery, less maintenance is defended; this method emphasizes the risk of late bleeding.

Thermal welding method

"Starion Thermal Welding System" works with the latest developed thermal welding technology, which gives the least heat damage to the environment. In this system produced by Starion Company, the heat energy produced at the tip of the probe can be used in two different modes. In the first mode, the veins in the tissue are contracted and the tissue is cut to minimize heat conduction to the second environment. You can find information about the device in particular and the probes >> Starion Instruments « Elite Healthcare - http://elitehealthcare.biz/blog2/our-products/starion-products/

Bloodless, seamless, painless tonsil surgery in the features advocated in this method, postoperative heat damage is reduced as the patient's pain complaint is reduced. However, during the procedure, because the bleeding is stopped, tonsils can be removed in a bloodless and clean surgical field. This method, which is not available in every hospital, has many advantages.

In this method, there are studies showing that the recovery time of the patient is shorter and the risk of complications is lower (Tissue welding tonsillectomy provides an enhanced recovery compared to that after monopolar electrocautery technique in adults: a prospective randomized clinical trial - http://link.springer.com/article/10.1007%2Fs00405-010-1333-9).

There are also studies showing that postoperative pain is much less in this method than other methods (A randomized control study -  http://www.sciencedirect.com/science/article/pii/S2090074013000224).

Click here for more information and tonsillectomy videos >> Tonsillectomy in Istanbul

Source links >>

- Fact Sheet: Tonsillectomy Procedures
- Study Finds Starion Instruments' Tissue Welding Technology Enhances Patient Recovery from Tonsillectomy Procedures
- Endoscopic-assisted tonsillectomy
- Hemorrhage after tonsillectomy: does the surgical technique really matter?
- Evidence-based practice: pediatric tonsillectomy
- Risk factors for postoperative hemorrhage following tonsillectomy

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

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