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COBLATION ADENOIDECTOMY PROCEDURE UNDER TRANSNASAL VIDEO-ENDOSCOPY CONTROL |
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Wednesday, 29 July 2009 09:19 |
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COBLATION ADENOIDECTOMY PROCEDURE UNDER TRANSNASAL VIDEO-ENDOSCOPY CONTROLDott. Lino Di Rienzo Businco, Rome – ItalyINTRODUCTIONCoblator system is not a new tool to do an old procedure - Always the hand (and the brain) moves the wand
- perfectionism of coblation surgery
- avoid FANS during preoperative days
- preservation of rhinopharyngeal mucosa with controlled coblation adenoidectomy
- reach and remove completely choanal intranasal adenoid, with no residual tissue (as happens with cold adenoidectomy)
- always think to a “selective and precise surgery” of the adenoid (saving normal adjacent mucosa and openings of Eustachian tubes) during procedure
- no thermal injury to the nasal-pharyngeal mucosa using coblator for adenoidectomy
EQUIPMENT PREPARATION - Insert the Procise XP Wand into the connector end of the patient cable. Align the raised dot on the wand handle with the black dot on the patient cable
- set the controller power level to 7-8 for ablation of the adenoids, and 3 for coagulation, depending on surgeon preference as judged by adenoid volume
- Nasal endoscope 0°, 2.7 mm diameter, connected to video-camera, for direct visualization of rhinopharynx cavity (no need of rubber catheter palatine retraction as when using mirror)
- Mc-Ivory open Mouth with proper size of pediatric tongue depressor
- Procise XP Wand malleable, curved till reach the superior portion of rhinopharynx and the opening to the Eustachian tubes
- Conformator to malleate and curve Procise Wand to the proper dimension of rhinopharynx without damage of suction function (see www.sidero.it )
- Cold saline solution flow connected to Wand for continue irrigation of operative field (if necessary drop saline solution also from nasal cavity)
- micro-suction tube for trans-nasal use
- surgical patties with local anesthetic
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