The video demonstrates tonsillectomy with monopolar diathermy technique.
Procedure conducted under general anesthesia with oral endotracheal intubation. Patient is placed in supine position with head in slight extension. No shoulder roll is used. Crowe-Davis mouth gag is inserted to keep the mouth open for the procedure. Extracapsular (total tonsillectomy, sub-capsular) techniques using a monopolar electrocautery started by grasping superior pole of the tonsil with curved long artery forceps. The tonsil retracted medially to identify junction between lateral edge of the tonsil and anterior tonsillar pillar. Using an monoplar electrocautery setting ( 15 W, spray mode), the anterior tonsillar pillar is incised from superior to inferior to help to get plane between tonsillar capsule and surrounding tissue. Then entire palatine tonsil with the capsule is dissected from surrounding tissue from superior to inferior. In some circumstances, uvula may interfere with superior pole dissection, retracting it with two appropriate size suction catheter make superior pole dissection readily easy.
Obstructive sleep apnea Recurrent tonsillitis Tonsil Stones (Tonsilloliths)
Tonsillectomy set Monopolar diathermy
Anterior and posterior pillar Tonsil
Advantage Faster and less intraoperative blood loss. Disadvantage More postoperative pain compared to cold technique.
Postoperative bleeding Postoperative pain