Tonsillectomy and adenoidectomy

PREOPERATIVE DIAGNOSIS:                            Tonsil hypertrophy and adenoid hypertrophy.

POSTOPERATIVE DIAGNOSIS:                         Tonsil hypertrophy and adenoid hypertrophy.

PROCEDURE:                                                         Tonsillectomy and adenoidectomy.

SURGEON:                                                               David Kay, MD

ANESTHESIA:                                                         General.

COMPLICATIONS:                                                 None.

ESTIMATED BLOOD LOSS:                                Minimal.

SPECIMENS:                                                           Tonsils and adenoids.

DESCRIPTION OF PROCEDURE:  The patient was taken to the operating room and placed upon the operating room table.  General anesthesia was induced via an endotracheal tube.  The head of the bed was turned 90 degrees and a shoulder roll was placed under the patient.  A Crowe-Davis mouth gag was placed in the patient's mouth and elevated on a Mayo stand.  The soft palate was palpated and no submucous cleft was present.  A red rubber catheter was placed through the left naris and brought out through the oral cavity.  The left tonsil was grasped at the superior pole with an Allis clamp and retracted medially.  Coblation was used to dissect along the tonsillar pillar until the capsule was identified.  Dissection continued from a superior to inferior direction until the entire tonsil was separated from the tonsillar fossa.  The identical procedure was then performed on the opposite tonsil, with similar findings.  Hemostasis was obtained bilaterally of the tonsillar fossae with the bipolar setting on the Coblation.  The adenoid pad was then visualized with a mirror and was noted to be hypertrophic.  The adenoid pad was obliterated with the Coblation technique, with hemostasis obtained using the bipolar portion of the Coblation.  The bilateral nares were then irrigated.  The stomach was suctioned with an orogastric tube, and the patient was reversed from anesthesia and taken back to the recovery room in stable condition.