Coblation Tonsillectomy our experience

Tonsillectomy happens to be the commonly performed surgery these days. Like any other surgical procedure this surgical procedure has also undergone tremendous technological changes. One such evolving change happens to be coblation tonsillectomy. Coblation technology is actually an offshoot of radiofrequency surgery. This technique involves passing radiofrequency energy through a conductive medium like isotonic sodium chloride or potassium chloride solution. This produces a plasma field which is composed of sodium and hydroxyl ions which ablates tissue. This tissue ablation takes place at (60-70° C) which is much lower than that achieved during other electro surgical techniques (400 – 600° C). This article attempts to discuss the use of this technology to perform tonsillectomy with special emphasis on sharing our experience with the system. This study involves critical appraisal of 25 coblation tonsillectomy surgeries performed at Stanley Medical college during the year 2013. Introduction: Tonsillectomy still remains the commonly performed surgical procedure. Surgical technique of tonsillectomy has undergone rapid evolution since the time of Celsus 30 BC who is credited with the first documented tonsillectomy procedure. Hook and knife method 1 performed by Aetius of Amida during 6 century shoud be considered as the first scientific attempt at removing tonsils. Paul of Aegina used forceps to completely extripate tonsils. This laid the foundation for tonsil guillotine. George Earnest Waugh of England was the first to use careful dissection method to remove the tonsil. He is also credited with the design of Waugh's tenaculum forceps which he used to dissect tonsil out of its bed (1909). Innovations that took place like the use of diathermy, harmonic scalpel, debrider were meant to reduce the operating time and bleeding during the procedure. Currently coblation is being attempted to remove tonsillar tissue. This process was invented by Philip E Eggers and Hira V Thapliyal in 1999. Coblation tonsillectomy received FDA approval in 2001. 3 Advantages of coblation tonsillectomy: 1. Less bleeding 2. Preservation of capsule is possible if done under magnification. If capsule is preserved there is less post operative pain 3. Tonsillar reduction surgeries can be performed in young children without compromising the immunological function of the lymphoid tissue