Endoscope holder-assisted endoscopic coblation tonsillectomy
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Endoscope holder‑assisted endoscopic coblation tonsillectomy Sapna Ramkrishna Parab1 · Mubarak Muhamed Khan1 Received: 4 May 2020 / Accepted: 27 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Tonsillectomy is being performed either with a headlight, surgical loupe magnification or with microscopic aid. We report the technique of endoscope holder-assisted endoscopic tonsillectomy using coblation. Coblation tonsillectomy has the primary advantage of limited thermal damage compared with alternative forms of surgery. Methods Our endoscope holder, primarily designed for endoscopic ear surgery, has been extrapolated for the use in twohanded technique of tonsillectomy. The method is described in detail. Conclusion Endoscope gives a panoramic view, better optics, magnified image of the bleeders and hence there is applicability of the endoscope holder for endoscopic tonsillectomy. Keywords Endoscope holder · Two-handed technique · Endoscopic tonsillectomy · Coblation · Day care · Postoperative bleeding
Introduction Tonsillectomy is the most common surgical procedure performed by ENT surgeons. The first tonsillectomy was performed by Celsius in 30 BC. There has been advances in the technique of tonsillectomy from the cold dissection, guillotine, electrocautery (bipolar or monopolar), harmonic scalpel, laser and coblation [1]. Cold dissection tonsillectomy or cold knife technique has remained the standard procedure of tonsillectomy since many decades. Haemostasis is achieved with either ligation technique or using electrocautery. Coblation tonsillectomy has been surfaced as a potentially appealing technology developed for this procedure. Coblation methods use ablation to remove tissue and for haemostasis [2]. The surgical outcome and success of any procedure depends on the optics and illumination. Tonsillectomy has been performed using either headlight, surgical loupe of 2.5–5D magnification or with the aid of microscope [3]. We use the endoscope and endoscope holder for Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00405-020-06249-4) contains supplementary material, which is available to authorized users. * Sapna Ramkrishna Parab [email protected] 1
Sushrut ENT Hospital and Dr. Khan’s ENT Research Center, Talegaon Dabhade, Pune, India
coblation tonsillectomy since 2016. The endoscope holder which was designed and developed for the two-handed endoscopic ear surgery [4–10] has been used in tonsillectomy. The use of endoscope during surgery not only widens the field of surgical vision, but allows an innovative surgical approach for the procedure.
Methods and materials Operating theatre requirements Zero-degree 4 mm 18 cm endoscope, 3 Chip or HD endoscopic Camera (Karl Storz, Germany), Endoscope holder and Coblator II (ArthroCare, Smith & Nephew, London, UK).
Design of the first Endoscope holder (Fig. 1) The endoscope holder that was developed for endoscopic ear surgery has been extrapolated for the
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