Jubilee Hospital Trivandrum.
Laser Tonsillectomy is getting more popular as the patients are more aware of their benefits. The post operative pain and chances of infection and bleeding is more in dissection technique. Laser tonsillectomy has its advantages as it cause minimal bleeding and less painful .So too it can be performed in patients who has bleeding disorders.
Laser has its place while doing OSA surgery, like vaporizing or debulking large tonsil mass.
Co2 laser
Laser used in my clinic is Co2 laser. Laser beam both dissect tissue and coagulate blood vessels. Lasers can be used to completely resect (laser tonsillectomy-LT), reduce (laser assisted serial tonsillectomy-LAT) or vaporize (laser vaporization tonsillectomy-LVT) tonsillar tissues
Laser Tonsillectomy under Local Anesthesia
A routine blood count and Consent is taken before surgery.
You are wide awake during the procedure and seated on the special laser ENT chair. The procedure is carried out in the laser room. You will be provided with some laser safety goggles and the procedure will be explained to you in detail by your surgeon. Local anesthetic spray -Xylocaine 10% will be sprayed into the back of your mouth. You will be advised to swallow this or spit it out after few minutes. It is bitter in taste. You may feel the throat numb and feel no sensation of air passing in the throat. This must be explained to the patient well in advance. The effect of the local anesthetic will wear off in 30-40 minutes.
The operation is an interactive procedure between surgeon and the patient. The procedure itself is started once you have taken a deep breath in and hold it. Lasering is done while you hold your breathe. A smoke evacuator is kept aside remove the smoke.
Post-operatively you are asked to avoid eating or drinking very hot food and drink for approximately one hour. This is because the area at the back of your throat will still be numb. After this period of time has passed you will be able to eat and drink entirely normally. Immediately post-operatively you are speaking normally and your ability to swallow is not affected. You are allowed to go home after one hour has passed and routine observations have been performed, during that time you will be given a cold drink. As you leave you will be given standard pain-killing medication, antibiotic and an antiseptic gargle. The gargle is to be used every six hours for the first seven days post-operatively; the painkillers should be taken as advised. After the operation there will be some whiteness in the back of your mouth which will stay for up to one week. This represents normal post inflammatory slough and is not a sign of infection.
Use saline-Salt in warm water gargle which will reduce the edema and wound heal fast.
If it is performed under local anaesthetic then at least two to three treatments may be required.
Laser Tonsillectomy under General anesthesia
The principle of this laser operation is that the delicate carbon dioxide laser in scanned mode is used to vaporize away tonsil tissue right down to the level of the capsule of the gland. This allows near-total removal of tonsil tissue, which may be causing problems such as sore throats, tonsil stones etc.
Its advantages lie in the fact that one is not completely exposing the muscle of the swallowing tube, as in a traditional tonsillectomy, pain levels are dramatically reduced. Also, because the space between the tonsil and the muscle of the swallowing tube is not entered, the risk of severe hemorrhage (bleeding) either during or after the operation, is minimal, since the major blood vessels lie in this area – which is why bleeding is relatively common with traditional tonsillectomy.
A further advantage lies in the fact that this is a no-touch technique. Therefore the risk of transmission of infected particles (HIV or Hepatitis) is in theory significantly reduced when compared with standard tonsillectomy.
The incidence of pain and bleeding is, in my experience, vastly better than conventional dissection tonsillectomy.
I feel that the advantages in terms of bleeding and pain outweigh the increased revision rate which is very rare .Revision surgery is usually performed under local anesthetic as in the tonsil reduction technique, after 12 months have passed from initial surgery.
Post operative care– On discharge pain killers, antibiotics, throat gargle are given.
For Appointment– call 0471-2334561/62/63/64, 6452020,407822 Fax-0471-2330925
Email: drpaulose@yahoo.com, drpaulose@yahoo.com
Clinic hours: Mon-Wed-Friday (8AM -1 PM)
Operation Days: Tue-Thu-and Saturdays (8AM-4PM)
To reach Jubilee Hospital: jubileehospitaltrivandrum
