IPG150

Electrosurgery (diathermy and coblation) for tonsillectomy (IPG150)

  • Interventional procedures IPG150
  • Issued: December 2005
    • Electrosurgery (diathermy and coblation) for tonsillectomy

      The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on electrosurgery (diathermy and coblation) for tonsillectomy.

      It replaces the previous guidance on coblation tonsillectomy (Interventional Procedures Guidance no. 9, September 200) and interim guidance on diathermy for tonsillectomy that was issued jointly with the British Association of Otorhinolaryngologists - Head and Neck Surgeons.

      • Description

        Tonsillectomy consists of two stages: removal of the tonsil, followed by control of bleeding (haemostasis).   In traditional ‘cold steel’ tonsillectomy, the initial incision in the mucosa is made with scissors, with the subsequent mobilisation of the tonsil usually carried out by some form of blunt dissection using either a specially designed dissector or dissecting forceps to manipulate gauze swabs or cotton wool to separate the tonsil from its bed.  Bleeding vessels are initially controlled by pressure on a swab in the tonsil bed and any residual bleeding is controlled with ligatures.  An alternative approach to dissection and haemostasis is electrosurgery (monopolar or bipolar diathermy).  These techniques were introduced around 40 years ago.  In the UK, bipolar diathermy dissection and haemostasis is more commonly used than monopolar.  Diathermy can also be used for haemostasis following traditional ‘cold steel’ techniques for dissection, either additional to ties or as the sole technique for control of bleeding, and ties are occasionally used as an adjunct to diathermy for haemostasis.  Coblation, a variation of electrosurgery that uses lower temperatures than diathermy, was introduced in the late 1990s.  It employs a bipolar probe to generate a radiofrequency current through a solution of sodium chloride.

      • OPCS4.6 Code(s)

        F34.7 Bilateral coblation tonsillectomy

        Note: Use a supplementary  code for concurrent excision of adenoid (E20.1 Total adenoidectomy or E20.4 Suction diathermy adenoidectomy )

        The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding

         

      • Other information

      No last updated information available

    • Guidance formats

      Query

Implementation tools and resources

  • None available

Patient

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Full Guidance

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.