Doing More With Less

Minimally invasive surgery options mean faster, easier recoveries.

Six-year-old Maci Merrell of Sulphur Springs was plagued with strep throat. "Her tonsils were swollen all of the time. We wondered how she could breathe sometimes," says her mom, Amber Cody. Doctors agreed that removing Maci's tonsils would help her avoid the repeat infections.

But Amber remembers the painful recovery she had when her tonsils were removed. "When I had my tonsils out, I felt absolutely terrible for several days. I remember my throat hurting really badly. That didn't seem to be the way it was with Maci," she says.

That's because today's surgeons can perform tonsillectomies with minimally invasive techniques, so people-mostly kids-leave the hospital more quickly, have less pain, eat and drink sooner, and get back to school faster. "I think the surgery lasted less than 30 minutes," Amber says. Their total stint in the hospital wasn't much longer than a school day. "We got there that morning around 8 and left about 2:30. They kept her a few hours after surgery to make sure she was doing OK," she adds.

In the tonsillectomy technique, called coblation, surgeons use a handheld wand to transmit a radiofrequency wave that cuts the tissue. In the past, tonsils were removed with a scalpel, and the next generation of treatments used electrical currents, which removed the tonsils but also burned the healthy tissue around them.

Bill Dietze, M.D., an ear, nose and throat surgeon on the medical staff at Memorial Hospital, uses coblation for virtually all his tonsillectomies. The only exception is if there's an abscess around the tonsils. "My granddaughter was the first one done by my colleague, and that night she was eating pizza," he says. For most of the patients, there are the benefits of this type of procedure:

• People take fluids well in the recovery room so there are few postoperative dehydration problems.
• There's no need for an overnight hospital stay.
• There's much less pain so people can eat and drink quickly.
• People need less pain medication, often just Tylenol.

We don't get the calls from mothers we used to regarding the pain," Dr. Dietze says. "Parents are feeling a lot more comfortable. Amber remembers what her surgery was like, and she can see the very obvious improvement."

Maci's recovery was smooth. "When she woke up she wasn't complaining, and the evening of surgery she ate cheese pizza, which I thought was amazing. I didn't eat for days after I had my tonsils out," Amber says. "Her throat hurt a bit the next day after a nap, but she drank some water and she was fine. Dr. Dietze prescribed pain medication, but she never took any." Maci's tonsils were removed on a Tuesday, and on Friday she joined her classmates for a school Christmas party. "She was glad to be able to have her party with her friends," Amber says.

Dr. Dietze expects that the coblation tools and technique will gain popularity for other surgical procedures. He cites gynecology, dermatology, oral surgery and eventually general surgery as fields where coblation may offer similar benefits.

Maci got an unexpected benefit from the tonsillectomy, too. Her grandmother, Surene Cody, who was the operating room nurse for the surgery, removed a loose tooth while Maci was under anesthesia.

By Stephanie Thurrott