The surgical removal of the tonsils is called tonsillectomy and that of the adenoids is called an adenoidectomy. Tonsillectomy and adenoidectomy, or T&A as it is commonly called, go together since in olden days whenever a tonsillectomy was performed, the adenoids were removed as well. Though, this practice is not followed in recent times, tonsillectomy and adenoidectomy are mentioned together as these are known to be the most commonly performed surgeries.
Prior to tonsillectomy surgery
Tonsillectomy (T&A) is usually performed as an outpatient basis and needs no hospitalization. However, the anesthesiologist needs to have a talk with the patient prior to the surgery, either the previous night or in the morning just before the surgery. This is done to know the patient’s medical and allergy history, which will help the anesthesiologist to use appropriate anesthetics, which will not pose a problem for the patient.
In order to avoid complications related to the anesthesia, the patient is advised not to eat or drink anything at least 6 hours before the surgery.
The tests that are ordered by the physician needs to be done at least a few days before the surgery.
The patient should avoid taking any NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen, aspirin etc. which have a blood thinning property, for at least 10 days before the surgery. If there is any doubt about any drug, it should be clarified with the particular surgeon who will be doing the surgery. However, the medications that the physician prescribes should be taken and even kept ready for post-surgery so that the patient gets the medications immediately without having to wait for the prescriptions to get filled.
In case any other sickness arises just before the surgery or the previous day, it should be intimated to the physician, who will be in a better position to analyse whether or not to go ahead with the surgery. If he deems fit, he will go ahead and get the surgery done or else will give a later date for the surgery.
A caregiver should accompany the patient for the surgery and back home and also to take care at home at least for 1 or 2 nights postsurgery.
The tonsillectomy surgery
The patient is first and foremost given an IV medication through an intravenous infusion line inserted while at the preoperative holding area. This is a form of anesthetic which is accompanied by a gaseous anesthetic given via a mask at the operating room. This general anesthesia puts the patient to sleep, which helps the physician to do the surgery. All throughout the procedure, the patient’s heart rate and oxygen saturation are monitored.
Once the anesthetics takes effect, the surgeon removes the tonsils and/or adenoids via the mouth, bleeding is stopped and the base of the tonsils and/or adenoids is sealed. The total procedure time maybe somewhere between 30-60 minutes. Once the patient has stabilized, he/she is transferred to the recovery room.
There are various methods available for removal of the tonsils and/or adenoids, namely, with the use of knife (which will require suturing to close the wound), electocautery (which uses a cauterizing unit that burns the base of the tonsils after the removal and thus does not require stitches); laser; harmonic scalpel and coblation.
Each technique has its own advantages and disadvantages, and the technique used for a particular patient will depend entirely on the physician treating that particular patient. However, as per the reports of many patients, the latest technique of coblation tonsillectomy is noted to have minimal pain, faster recovery and the least number of post-surgery complications.
In this context, it is advisable to choose an experienced physician to perform the surgery, who will be better able to guide in choosing the correct and most suited surgical technique.