A New Instrument for Use with Nd:YAG in Tonsillectomy

Abstract

In tonsillectomy, unexpected bleeding can be one of the most troublesome surgical procedures to perform. To resolve some inherent problems, we have developed a new elevator with contact Nd:YAG laser probe for blunt dissection around the tonsillar capsule. Of 63 cases of laser tonsillectomies performed over 5 years, 51 cases were performed using conventional contact Nd:YAG laser probe and a chisel type dissector. Tonsillectomy in the remaining 12 cases was undertaken by the newly developed elevator with contact Nd:YAG laser probe. We compared clinical evaluation between laser and conventional procedures. Additionally, the advantage of laser tonsillectomy is discussed.

Pediatric Tonsillotomy with the Radiofrequency Technique: Less Morbidity and Pain

“…In other studies, different kinds of electro‐surgery have been used for TE, but, although the dissection can be smooth and almost blood free, one does not observe the gain of reduced pain. 3–6 Leaving the tonsillar pillars intact with the tonsillar capsule appears to be the reason for less pain.…”

“…They all appear to work well for the removal of the tonsils with less bleeding, but they do not reduce the postoperative pain as much. 3–6 However, if a partial intracapsular TE (tonsillotomy [TT]) is performed, the postoperative morbidity is remarkably reduced. 7,8 The tonsillar tissue per se does not appear to be as pain sensitive and heals rapidly after the surgery.…”

Long-term effects of intracapsular partial tonsillectomy (tonsillotomy) compared with full tonsillectomy

“…A recent study shows that currently about 50% of the American ENT specialists use one or another electrosurgical options for tonsillectomy [3]. These methods all seem to work well for the removal of the tonsils with less bleeding, but they do not necessarily reduce the post-operative pain [4][5][6][7].…”

History and Current Practice of Tonsillectomy

“…Linder et al 15 perfected use of the CO 2 laser for tonsillectomy in children. Moriyama et al, 16 in trying to resolve the problem of bleeding, developed an elevator with a contact Nd:YAG laser probe for blunt dissection around the tonsillar capsule. Ultrasonic technology, radiofrequency, and powered instrumentation for tonsillectomy are described elsewhere in this supplement.…”