Snapshots of an endoscopic adenoidectomy with coblator. Note that the excellent visualization with an endoscope. There is minimal bleeding with coblator.

ADENOIDECTOMY Adenoidectomy is an operation done to remove the adenoids. It is a very common operation done in children though sometimes it is performed in adults as well. The surgery is performed under general anaesthesia. There are many ways to remove the adenoids. I will describe here my technique of performing this operation. The surgery is performed through the mouth. A Boyle Davies retractor is used to open the mouth wide. The retractor is locked in position. The soft palate is retracted using small tubes. A high definition camera which is attached to the eye piece of a 70 degree endoscope is introduced through the mouth to visualise the nasopharynx. The camera system provided an excellent view of the adenoids on a high definition 20 inch LCD monitor. The adenoids can now be removed under direct vision. A Coblator is used to remove the adenoids. The coblator provides excellent hemostasis during the surgery with very minimal blood loss. As the surgery is performed under direct vision, it is possible to do a more complete operation. At the end of the surgery hemostasis is secured with monopolar and bipolar diathermy. The surgery takes about 20 to 30 minutes. The child is then monitored in the recovery room for about half an hour and then in the ward for a few hours before being discharged.

What to expect after adenoidectomy? Some pain and discomfort is common after adenoidectomy. Pain killers and antibiotics if necessary are prescribed. The child should be able to take soft diet on the same day or the next day. It is advised to avoid hot and spicy food for about 2 weeks. It may take up to 2-3 weeks for the healing to take place.

What are the risks? Children usually tolerate the surgery very well. Apart from the risks of general anaesthesia there is a risk of infection and bleeding from the surgical site.

Outcome: The surgery has an excellent outcome. Most parents are very pleased with the results. He child is able to breathe better, sleep better, has less ear infections or sore throats and has a much improved quality of life. They even perform better in school.