Coblation Emerges as Tonsillectomy Option

Sept. 23, 2005 -- A low-temperature device for removing a child's tonsils offers surgery with less lingering pain than tissue-burning techniques.

It's called Coblation. The device uses radio waves that turn a simple salt solution into a stream of powerfully charged ions. These ions don't get very hot. But they carry so much energy, they cut right through tissues.

Electrocautery does much the same thing but uses higher temperatures to burn through tissues. A new study, presented at this week's annual meeting of the American Academy of Otolaryngology, compares Coblation to electrocautery.

The report, by Sukgi S. Choi, MD, of Children's National Medical Center in Washington, D.C., is based on hospital records from nearly 2,000 kids aged 1 to 18. Doctors used electrocautery on 1,252 kids and Coblation on 745 kids.

Choi's team looked at several problems that can occur after tonsillectomy. These are heavy bleeding in the first 24 hours after surgery, heavy bleeding more than 24 hours after surgery, and dehydration (from less oral intake due to swallowing pain) requiring a trip to the emergency room.

Choi reports that:

• Coblation and electrocautery have the same risk of serious bleeding: less than 1% for early bleeding, and about 3%-5% for later bleeding.
• More kids had to go to the emergency room for dehydration after electrocautery (5.1%) than after Coblation (3.1%).

Choi concludes that Coblation may cause less postoperative pain than electrocautery.

A caution about Coblation therapy came from a 2004 report on patients treated in the U.K. In that study, three times as many Coblation tonsillectomy patients had postoperative bleeding as patients with tonsillectomies performed with traditional "cold steel" instruments.

Other tonsillectomy techniques, which were not looked at in the study, include use of ultrasonic energy and laser technology.