Tonsillectomy with Radiofrequency Ablation (Coblator) Technique

Video Type: CVideo
  • 2-5 min videos of a particular surgery or technique. These again show major events in the surgery
  • Clearly annotated and narration is a must in these videos
  • These have clear but concise abstracts are not able to be indexed in PubMed
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Author: Thomas Mitchell
Published:
Specialties: Otolaryngology, Pediatric Otolaryngology
Schools: University of Texas Medical School
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Basic Info

Tonsillectomy is among the most common surgical procedures performed in children.  The two major indications are oropharyngeal airway obstruction and recurrent or chronic infections of the oropharynx.  In this video, radiofrequency ablation, or Coblation (controlled ablation), is the technique used to ablate the tonsils.  This technique uses low-temperature radiofrequency and saline to create a plasma field that dissolves tissue.  It is generally safer that high-temperature electrocautery and allows for precise removal of tissue without burning nearby structures.

Contributors:

  • Soham Roy (University of Texas at Houston Medical School)
  • Thomas Mitchell (University of Texas at Houston Medical School)
  • Steven Curry (University of Texas at Houston Medical School)
Advanced

Procedure

Tonsillectomy is among the most common surgical procedures performed in children. The two major indications are oropharyngeal airway obstruction and recurrent or chronic infections of the oropharynx. In this video, radiofrequency ablation, or Coblation (controlled ablation), is the technique used to ablate the tonsils. This technique uses low-temperature radiofrequency and saline to create a plasma field that dissolves tissue. It is generally safer that high-temperature electrocautery and allows for precise removal of tissue without burning nearby structures.

Indications

Obstruction or chronic/recurrent infections of the oropharynx

Contraindications

Active local infection, certain hematologic disorders, certain pharyngeal anatomical abnormalities

Instrumentation

Setup

The patient is placed under general anesthesia. A mouth retractor is placed to allow for visualization of the oral cavity.

Preoperative Workup

Complete history and focused physical with anesthesia evaluation

Anatomy and Landmarks

The tonsils are situated in the lateral walls of the posterior oral cavity between the tonsillar pillars.

Advantages/Disadvantages

Complications/Risks

Pain, bleeding, infection, upper airway obstruction, laryngospasm, airway edema

Disclosure of Conflicts

None

Acknowledgements

Soham Roy – surgeon; Thomas Mitchell – video editing; Steven Curry – video recording

References

1) Baugh RF, Archer SM, Mitchell RB et al. Clinical practice guideline: tonsillectomy in children. Otolaryngology head and neck surgery. 01/2011; 144:S1
2) Omrani MM. Journal of research in medical sciences: Coblation versus traditional tonsillectomy: A double blind randomized controlled trial. Isfahan University of Medical Sciences; 01/2012;17:45.
3) Smith & Nephew COBLATION Facts: http://mytonsils.com/coblation-facts.aspx

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