Purpose of Your Proposal:

This proposal aims to share advanced surgical techniques in intracapsular tonsillectomy and endoscopic adenoidectomy using Coblation, offering participants both theoretical insights and practical guidance. Drawing on extensive personal experience in national and international live surgery courses, this instructional session will promote safer, less morbid approaches to adenotonsillar surgery.

Description:

Intracapsular tonsillectomy and endoscopic adenoidectomy represent a paradigm shift in the surgical treatment of adenotonsillar hypertrophy and recurrent infections, particularly in the paediatric population. The use of Coblation technology allows for precise tissue removal with minimal thermal damage, significantly reducing postoperative morbidity.

This instructional course will provide an evidence-based overview of the indications, techniques, and outcomes associated with intracapsular tonsillectomy and endoscopic adenoidectomy. Participants will have access to high-quality 3D surgical videos, detailed step-by-step technique demonstrations, and a comprehensive review of recent literature supporting this minimally invasive approach.

Additionally, the course is supported by the organiser’s active participation in national and international training programmes in this technique over recent years, including live surgical courses.

Outcome Objectives:

By the end of this course, participants will be able to:

Understand the anatomical and physiological principles underlying intracapsular tonsillectomy and endoscopic adenoidectomy.

1. Recognise the advantages of Coblation over traditional dissection and electrocautery techniques.

2. Identify appropriate candidates for this surgical approach, particularly among paediatric patients with obstructive sleep apnoea or recurrent infections.

3. Perform a step-by-step analysis of the surgical technique using Coblation, aided by instructional 3D video materials.

4. Evaluate clinical outcomes, including reduced postoperative pain, lower bleeding risk (up to 95% less), faster recovery, and low recurrence rates (~2%).

5. Incorporate this technique into clinical practice safely and effectively.

Background:

Traditional tonsillectomy and adenoidectomy techniques are associated with significant postoperative discomfort and risk of bleeding. Over the past decade, intracapsular tonsillectomy has gained traction as a safer alternative, preserving the tonsillar capsule and thereby reducing exposure of muscle and neurovascular structures. When combined with endoscopic adenoidectomy, this approach ensures complete and precise removal of obstructive tissue under direct vision.

Coblation, or controlled ablation, uses radiofrequency energy in a conductive medium to create a plasma field that dissolves tissue at relatively low temperatures. This minimises collateral damage and inflammation, which translates to a faster and less painful recovery.

Current evidence demonstrates that intracapsular Coblation tonsillectomy is associated with a recurrence rate of less than 2%, while significantly lowering postoperative haemorrhage. These advantages make it a highly attractive option, especially in young children.