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New surgery technique to be demonstrated

7 November 2005

New surgery technique to be demonstrated at Hawke’s Bay Hospital

Dr Michael Timms, a consultant otolaryngologist from Lancashire, England, will be at Hawke’s Bay Hospital on Wednesday 9 November, to demonstrate coblation-assisted tonsil surgery.

The surgery will be performed on two children and an adult at an operating theatre in Hawke’s Bay Hospital, and simulcast to the hospital’s education centre, where ear, nose and throat surgeons and theatre staff from around the country will be assembled. It will also be simulcast to the Christchurch School of Medicine, so South Island surgeons can observe the procedures.

Hawke’s Bay District Health Board’s clinical director of surgery and otolaryngologist, Dr David Grayson, together with fellow Hawke’s Bay otolaryngologist Dr Paul Mason, were the first in New Zealand to trial the new technology and technique for removal of tonsils and adenoids.

“Coblation surgery provides a much gentler way to remove both the tonsils and adenoids. It also has potential to be used in other surgical specialties. This advanced surgical technique results in reduced pain, less bleeding and faster recovery for patients. Unlike the traditional method, coblation technology literally ‘vaporises’ the tonsils. As there’s no cutting or heat involved, there’s no charring or burning of healthy tissue, which is great news for patients.

Coblation is derived from the term “controlled ablation” It combines radiofrequency energy with a natural saline solution to gently and precisely remove tissue leading to a fast and easier recovery. Coblation surgery was first carried out overseas in 1997.

“We’ve completed 15 cases in Hawke’s Bay using this innovative technique, and without exception the patients have made a much speedier recovery than we would expect with the traditional method ...we’re very enthusiastic about this technology which can definitely lead to improved outcomes for our patients.

Dr Grayson was quick to add that new technology did come at a cost. The disposable ‘wands’ used for each procedure were in the region of $200 each. “We are weighing up the costs and benefits, but I have to say we have been very impressed with the results and research. Around 300 tonsillectomies are performed in Hawke’s Bay each year.

Dr Timms, who will be demonstrating the technique has been performing coblation-assisted tonsillectomies and other upper airway surgery since 2000. He was one of the pioneers of this method and has published several articles demonstrating the benefits for patients.

The surgery demonstrations follow the New Zealand Society of Otolaryngology, Head & Neck Surgery National Conference which is being held in Napier from Sunday 6th - Tuesday 8th November. Around 100 delegates are expected to attend the conference.

Time: the surgery is scheduled to start at 8:30am

Background information & frequently-asked questions
Edited from information provided by ArhroCare Corporation

The Technology

Coblation tonsillectomy utilises a unique, low-temperature technology that has been clinically shown to speed a child’s return to normal activity and diet, and decrease pain, post-surgical narcotics use and the chance of re-bleeding when compared to older, heat-based technologies such as electrocautery.1,2 By combining radiofrequency energy with a saline solution, Coblation is able to gently and precisely remove tonsils without damaging surrounding healthy tissue.

Since its introduction in 1997, Coblation has been used in more than 2 million surgical procedures worldwide in a variety of arthroscopic, spinal and dermatological surgical applications. Cleared by the FDA in July 2001 for tonsillectomy, surgeons have performed more than 500,000 Coblation Tonsillectomy procedures around the globe.

Patient Benefits

Results of clinical studies confirm that children whose tonsils were removed by the Coblation Tonsillectomy procedure experienced less pain and recovered more quickly — including returning to a normal diet in half the amount of time — than those who underwent other surgical techniques.1

Instead of the prolonged recovery period (up to two weeks) common with other tonsillectomy methods, studies have shown that Coblation patients are back to their normal diet more quickly, in 2.4 days versus 7.6 days on average 2 , reducing the risk of dehydration and rapid weight loss.

Coblation Tonsillectomy typically takes about 20 minutes to perform and has a lower incidence of post-operative complications versus conventional tonsillectomy procedures. According to one published study, doctors received 59 percent fewer patient calls or visits for complications during days one through 14 post-surgery with Coblation Tonsillectomy versus tonsillectomy with electrocautery 3 .

¹ Temple RH, Timms MS. Paediatric Coblation Tonsillectomy. International Journal of Pediatric Otorhinolaryngology, 2001; 61: 195- 198.
2 Stoker KE, Don DM, Kang DR, et al. Pediatric total tonsillectomy using Coblation compared to conventional electrosurgery: a prospective, controlled single-blind study. Otolaryngol Head Neck Surg. 2004;130(6):666-675.
3 Walner, D, Pediatric Tonsillectomy: Coblation vs. Electrocautery, Abstract for the Scientific Program at the American Academy of Otolaryngology (AAO), New York, NY, September 20-23, 2005.

Coblation Tonsillectomy - Frequently Asked Questions
Edited from information provided by ArhroCare Corporation

What are the tonsils?
Tonsils are ball-like areas of soft tissue on both sides of the throat. They help the body fight
infection by filtering out germs that enter the body through the mouth and nose. There are other tissues like the tonsils that help filter out germs too. They are called the adenoids.

What are the adenoids?
The adenoids also help the body fight off infection. The adenoids are the areas of soft tissue
right behind the nose.

What types of problems can someone have with their tonsils and adenoids?
Sometimes the tonsils and/or the adenoids are so enlarged that they block the throat and
breathing airway. This can cause difficulty breathing and other serious health problems. A
child’s doctor may call this condition tonsillar hypertrophy or obstruction.
While helping the body fight off germs, the tonsils and adenoids may also get infected. If the
infection is great enough to cause inflammation, this condition is called tonsillitis.

What is tonsillectomy?
Tonsillectomy is a surgery in which the tonsils are removed from the throat. An “adenoidectomy” is a similar surgery that removes the adenoids.

What is tonsillitis?
Tonsillitis refers to the inflammation of the tonsils caused by an infection. Recurring infections in the tonsils could lead to chronic tonsillitis and other chronic infections. Tonsillitis is usually contagious and is spread just like a cold; that is, through coughing, sneezing, etc.

What causes tonsillitis?
Viruses and bacteria can cause tonsillitis. A weak immune system may also lead to tonsil infection. Almost all children get at least one tonsil infection in their lifetime.

What are the symptoms of tonsillitis?
The symptoms of tonsillitis include:
• Fever
• Persistent sore throat
• Redness of the tonsil area
• Yellow discharge on the tonsils
• Tender lymph nodes on both sides of the neck

What are chronic infections and why are they treated with tonsillectomy?
Infections in the tonsils and adenoids that keep coming back are called chronic infections. If these infections are not stopped, they could cause more serious health problems. A child’s doctor may first prescribe antibiotics to fight infections. If antibiotics do not work, the doctor may recommend tonsillectomy and/or adenoidectomy. Removing the tonsils and/or adenoids helps to prevent infections from coming back.

What is Coblation ® Tonsillectomy?
Coblation Tonsillectomy and Adenoidectomy is a gentler way to remove both the tonsils and adenoids. This innovative surgery results in very little pain and fast recovery for patients. Derived from the term "controlled ablation," Coblation removes or ablates tonsil tissue with little harm to surrounding healthy tissue.

Coblation is not a heat-driven process, therefore it does not char or burn healthy tissue like conventional electrosurgery and laser surgery. It combines radiofrequency energy with a natural saline solution to gently and precisely remove tissue leading to a fast and easier recovery. Coblation technology has been used in more than 2 million surgeries, including more than 500,000 ear, nose and throat surgeries worldwide.

Why is Coblation Tonsillectomy a better choice?
Older ways of removing the tonsils and adenoids include cutting or burning. These methods could cause extensive pain and may damage healthy tissue around the tissue that is removed.

Coblation is an advanced technology that uses gentle radiofrequency energy with a saline solution - to quickly and safely remove tonsils and adenoids. Coblation does not remove the tonsils or adenoids by heating or burning preserving healthy surrounding tissue.

What are the benefits of Coblation Tonsillectomy?
• Fewer ‘bad days’ - Patients report a better overall experience with Coblation
Tonsillectomy after surgery when compared to other procedures. Studies show that
patient calls and visits to the doctor due to problems after surgery are significantly less with Coblation Tonsillectomy.
•Faster recovery - Coblation Tonsillectomy has been shown in clinical studies to speed a child’s return to normal activity and diet. On average, patients return to a normal diet in
2.4 days after Coblation, versus 7.6 days after electrocautery.
•Less pain - Coblation Tonsillectomy has also been shown to decrease pain and use of medications after the procedure.


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