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Updated: Feb 24, 2026

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

Published on: November 6, 2019

Mejora de los resultados de la amigdalectomía: una experiencia de cinco años de evolución de la práctica en un centro

A Shenoy¹, M Farr¹, Z Sheikh¹

¹Sheffield Children's Hospital, UK.

Annals of the Royal College of Surgeons of England

|February 23, 2026

Abstracto

Introduction:

Tonsillectomy techniques have evolved significantly. Here, we show how our practice changed based on evidence from nearly 2,600 tonsillectomies over five years at a tertiary paediatric centre.

Methods:

This is a case series with retrospective analysis of data from electronic records for children undergoing tonsillectomies between 2017 and 2022 at a tertiary paediatric centre.

Results:

A total of 2,583 tonsillectomies were analysed. The main indication was sleep-disordered breathing (SDB) (82%). In the 2017 audit phase, secondary and primary bleed rates were 6.2% and 0.5%, respectively. Readmission rates for post-tonsillectomy haemorrhage in 2017 were 6% for extracapsular bipolar dissection, 9.8% for extracapsular Coblation tonsillectomy (ECT), and 0% for intracapsular Coblation tonsillectomy (ICT). This led to an increase in ICT use from 22% in 2017 to 74% in 2022, while bipolar dissection and ECT declined to 6% and 12%, respectively. The readmission rate dropped from 9.1% (2017) to 5.2% (2022), and overall bleed rates fell from 6.2% to 4.4%. Bleed rates varied by technique: ICT 1.9%, bipolar dissection 7.1%, ECT 9.7%. Seven patients required revision surgery (<1%); surgeon's grade did not significantly impact outcomes. Registrars increasingly performed tonsillectomies using ICT (27.4% in 2017 to 76.5% in 2022).

Conclusions:

ICT is our standard technique for SDB due to its lower rates of postoperative haemorrhage and return to theatre. Given the higher haemorrhage rates with ECT, extracapsular dissection is preferred when needed. Registrars are trained in ICT. This shift, based on evidence of lower morbidity, shows how outcome evaluation and technique evolution can minimise complications, enhancing safety for the children we treat.

Palabras clave:

amigdalectomía por Coblación apnea obstructiva del sueño hemorragia postamigdalectomía amigdalectomía amigdalitis

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