Adenotonsillectomy.pptx

Instruments for adenotonsillectomy

1. Adenotonsillectomy For AT & OT Students Dr. Adhishesh Kaul

2. Procedure Surgery to remove adenoids and tonsils from a patient Site Adenoids: Nasopharynx – Behind Nose Tonsils: Oropharynx – After oral cavity

3. Operative Procedure Arrange the instruments Position the patient Prepare the patient Surgeon operates

4. Positioning Shoulder Bag Head Ring

5. Operative Instruments - Basics Unolock Syringe – 2cc syringe with 26G (brown) long needle Lignocaine (2%) with Adrenaline Feeding tube/ suction catheter Syringes – 10CC/ 5CC Normal Saline Betadine and spirit Head drape Spinal needle Camera set Light source Gauze pieces Cotton Balls BP Handle Blade

6. Surgical Instruments

7. Boyle Davis Mouth Gag with Tongue Blade

8. Magauren Plate

9. Draffin Bipod

10. Look of the patient

11. St. Clair Thompson Adenoid Curette with cage

12. Steps for Adenoidectomy Position the patient – Rose position Using mouth gag, and draffin bipod : open the mouth If under vision – (using endoscope) : Some surgeons may infiltrate adenoid tissue with 2% lignocaine with adrenaline Some surgeons may pass feeding tube from nose and pull out from mouth to elevate the soft palate Using adenoid curette, shave the adenoids orally

13. Dennis Browne Tonsil holding forcep

14. Gwyne Evan tonsillar dissector

15. Mollison tonsillar dissector with pillar retractor

16. Eve tonsillar snare

17. Yankauer suction tube

18. Steps of tonsillectomy Position the patient – Rose position Using mouth gag, and draffin bipod : open the mouth Infiltrate tonsils with lignocaine with adrenaline Pull the tonsils medially – using tonsil holding forcep Give an incision at mucus membrane where it reflects from anterior pillar Using pillar retractor and tonsillar dissector dissect the tonsils till lower pole Using eve tonsillar snare, cut the tonsils Some surgeons may tie a knot before dissecting the tonsils

19. Newer Techniques Electro-cautery Laser Tonsillectomy Micro debrider assisted Harmonic scalpel Coblation tonsillectomy

20. Complications Hemorrhage /Bleeding Injury to adjacent structures – soft palate, uvula, tongue Injury to teeth Aspiration of blood Infection Scaring of soft palate Tonsillar remnants

21. That’s All for The Day Thank You Good Luck