Paediatric tonsillectomy is always performed under general anaesthesia. Removal of the tonsil can be done in a conventional manner, excised with common surgical instruments, as well as with a coblation procedure.
During conventional excision, the otolaryngologist removes the inflamed tissue using scissors, raspa, and an electrocautery. The advantage of the procedure is that there is no need for sutures due to minimal tissue damage, therefore healing is faster. In our experience, after surgery, the patient feels less pain than with laser-assisted or radiofrequency methods.
One of the biggest advantages of the coblation or cold plasma cutting procedure, in addition to the faster wound healing, is also the much milder wound pain after the operation. The essence of the method is to create a focused plasma with the electrically excited electrolyte (NaCl), which breaks down the tissue molecular bonds at low temperatures, the cutting is practically done by evaporating the tissues. As a result, a uniform, fine anatomical surface is formed at the site of the incision, where the wound does not require suturing either, because the plasma incision occludes the small blood vessels at the same time, therefore no bleeding occurs. This significantly shortens the post-operative healing time and results in less pain and discomfort after surgery as no sutures are required either.
Tonsillectomy is performed orally, the mouth is held open by a metal mouth spreader that rests partly on the front teeth and partly on the tongue. Tonsil surgery is performed under intubation anaesthesia. This means that during the operation the child is asleep, a tube is inserted into their trachea through which he is breathed. This protects the lower respiratory tract from getting blood from the surgical wound.
The otolaryngologist excises the tonsil with its capsule from the muscle bed with surgical instruments or coblator according to the chosen procedure.
Adenoidectomy can also be performed at the same time as tonsillectomy.