Biopolar radiofrequency, also known as coblation, is a “gentle” way to remove both tonsils and adenoids. Radiofrequency, or RF, is a form of energy like radio waves. Bipolar RF tonsillectomy uses this energy in a carefully controlled surgical process that separates the tissues of the tonsils and adenoids while causing very little harm to the surrounding healthy tissue. This results in minimal pain and fast recovery for patients 1,2. The procedure can be used to perform total tonsillectomy (subcapsular) or sub-total tonsillectomy (intracapsular) depending on the patient's needs.
Bipolar RF tonsillectomy gently separates the tissues of the tonsils and adenoids while causing very little harm to the surrounding healthy tissue.
Intracapsular bipolar RF tonsillectomy
For intracapsular tonsillectomy, the surgeon uses a bipolar RF device to remove 90-95% of the tonsils. A layer of tonsil tissue is left over the throat muscles thereby protecting the throat muscles from exposure and reducing post-operative pain and recovery time compared to standard tonsillectomy (electrocautery or cold knife). The intracapsular method is not appropriate for recurrent or chronic tonsillitis.
Bipolar RF tonsillectomy gently separates the tissues of the tonsils and adenoids while causing very little harm to the surrounding healthy tissue.
Subcapsular bipolar RF tonsillectomy
For subcapsular, tonsillectomy, the surgeon uses the bipolar RF device to remove the tonsil or adenoid tissue completely.
How it works
Bipolar RF tonsillectomy is a low-temperature procedure. Instead of charring or burning, it uses RF energy with a natural salt (saline) solution to remove tonsils and adenoids while sealing blood vessels.
Advantages
Flexibility: Bipolar RF can be used to perform both total (subcapsular) and sub-total (intracapsular) tonsillectomy. The bipolar RF device also allows the surgeon to cauterize blood vessels and stop bleeding without additional instrumentation.
Fewer “bad days”: Patients report a better overall experience bipolar RF tonsillectomy compared with other procedures. Studies show that patient calls and visits to the doctor due to problems after surgery are significantly less with bipolar RF tonsillectomy.1
Faster recovery: Bipolar RF tonsillectomy patients tend to return to a soft diet and normal activity sooner than patients who undergo more traditional electrocautery tonsillectomy. 2
Minimal pain: Bipolar RF tonsillectomy patients experience less pain after the procedure than patients who undergo more traditional electrocautery tonsillectomy.2,3
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Disadvantages
Tonsil regrowth: As with any sub-total (intracapsular) tonsillectomy method, there is a chance of tonsil regrowth and recurrent infection.
Expense: The equipment used for biopolar RF tonsillectomy methods is expensive compared to scalpel or electrocautery methods.
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- Stoker K, Don D, Kang P, Haupert M, Madgy D. Total Tonsillectomy with Coblation Compared to Conventional Electrocautery in Pediatric Patients. Otolaryngology, Head and Neck Surgery. 2004; 130 (6):666-675.
- Temple RH , Timms MS. Paediatric coblation tonsillectomy. Int J Pediatric Otorhinolaryngology 2001;61:195-198.
- Timms MS, Temple RH . Coblation tonsillectomy: a double blind randomized controlled study. J Laryngology & Otology. 2002;116:450-452.