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Popsicles are likely to stay around
but there is new proceudre for removing tonsils
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| By:Denise Jenkin, News Reporter |
August 07, 2000 |
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Doctors want procedure to be less painful |
It used to be almost a rite of passage for children: surgery to remove their tonsils, followed by a few weeks of a Popsicle diet to soothe the pain.
Dr. Donald Kitain is out to change that. The Commerce Township otolaryngologist has no problem with frozen treats, but he's trying to reduce that post-surgery pain. He and other doctors are using a new type of surgical tool to make the traditional tonsillectomy a little easier on patients.
Called the Harmonic Scalpel, this equipment already has been used for 10 years in some abdominal and gynecological surgeries. Today, it is helping tonsillectomy patients feel better and recover faster. The high-tech instrument runs on ultrasound waves, and moves at a speed of 55,500 cycles a minute, far faster than the human eye can see.
Nearly 600,000 tonsillectomy procedures are performed each year in the United States. The procedure is considered appropriate in patients who have frequent infections, airway obstruction causing sleep apnea, or generally large tonsils that may cause difficulty in eating or drinking. Most surgeries are in children, but some adults also may have them removed.
The number of tonsillectomies each year tends to vary with trends in the medical field, Kitain said.
"In the '60s it was common to remove the tonsils just because they were there and they were large," he said. "In the '70s and '80s the feeling swung to the other end of the pendulum - that they shouldn't be removed. It has sort of swung back to the middle. Now there are specific guidelines to follow in deciding on surgery."
The current preferred method for traditional tonsillectomy is electrosurgery, using an electric cauterizing scalpel. The heat of the scalpel, up to 450 degrees, slices through the tissue while sealing off blood vessels. Laser surgery works using similar high temperatures, but with intense light instead of electrical energy. The problem is: all that heat and energy can hurt the patient, sometimes charring the remaining tissue, Kitain said.
It takes about two weeks for a complete recovery. Major risks include bleeding as well as dehydration in patients who avoid painful eating and drinking.
Kitain is enthusiastic about offering patients the Harmonic Scalpel instead. The ultrasound motion of the scalpel precisely cuts through the tissue at a temperature of 50 to 100 degrees, Kitain said. It then helps the tissue to seal without searing temperatures. He does keep the cauterizing tool nearby for stubborn bleeds.
Kitain was the first Michigan surgeon to use the Harmonic Scalpel for tonsillectomies four months ago. Now, parents are reporting that some kids will go their entire recovery period without asking for any pain medication. Others may use it only on the day of surgery.
"I'm not saying there is no pain," the doctor said. "But it is a lot less. Patients in general begin to feel better faster because they are going to suffer less pain. There is less of a chance of dehydration because of the reduced pain."
Four-year-old Sarah Wiggins may not understand the difference between various scalpels, but she does know she's not getting Popsicles for breakfast any more like she did right after her surgery.
Her mom, Angel Wiggins, said she was surprised by her daughter's speedy recovery from Kitain's outpatient surgery in June.
"That night of the surgery she was up, around and doing things," Angel Wiggins said. "After one or two days she was eating soup and mashed potatoes. I know we didn't use her whole bottle of pain medication.
"If there is less pain, less bleeding and less scabbing, why not? I thought it turned out great."
For Sarah, it all really comes down to one thing: "I didn't cry," she said proudly. |
| ©The Oakland Press 2000 |
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