The feasibility of acute tonsillectomy in patients with recurrent episodes of acute tonsillitis

Coblation tonsillectomy will be performed by a single senior ENT surgeon with more than 20years of operating experience at a metropolitan hospital in Sydney, Australia. The recruitment and selection of suitable adult patients to undergo this procedure will be made on a case by case basis, taking into account personalised clinical history and examination findings. A number of factors will be considered, including frequency and severity of episodes of recurrent tonsillitis and the presence of co-morbidities. Tonsillectomy is an operation which can only be performed once on a patient, since the tonsil is removed during in the course of the operation. Tonsillotomy is not being performed. Coblation tonsillectomy is a newer technique which involves dissecting the tonsil from the tonsil bed using a localised plasma field created on a "tonsil wand". A radiofrequency current is produced by a generator and this passes through a field of saline at the tip of the tonsil wand, breaking the molecular bonds to create ions which thereby generate the plasma field for tissue dissection. The plasma field is kept localised at the head of the tonsil wand by the continuous supply and suction of the saline stream. This differs from the traditional techniques used in tonsillectomy, such as "cold steel" tonsillectomy and "diathermy" tonsillectomy. In cold steel tonsillectomy, instruments used include scissors and dissecting forceps, and haemostasis may be achieved with the use of ties, while diathermy tonsillectomy involves the use of electrocautery energy to dissect through the peritonsillar plane. Intra-operative time for coblation tonsillectomy is variable depending on the difficulty of the individual case, but typically would take approximately half an hour or up to one hour. This does not include time for anaesthesia induction and recovery.