There has been increased interest in the adoption of an intracapsular tonsillectomy technique in the UK in recent years. The adoption of any newer surgical technique inevitably is accompanied by an educational need.

This paper aims to outline the equipment preparation and surgical steps for intracapsular coblation tonsillectomy, including recognition of the tonsillar capsule. The paper also discusses how to avoid and deal with common complications and technical difficulties.

This study compared post-tonsillectomy pain scores and recovery using the coblation-only technique, comparing extracapsular versus intracapsular approaches.

A prospective study was performed in our paediatric ENT department. Pain scores were recorded on days 0, 2, 4 and 8, using a visual analogue scale ranging from 0 (no pain) to 10 (extreme pain). Information was also collected on: return to normal fluid and solid intake, and any post-operative visits to primary care.

In total, 101 patients were included in the analysis. Average pain scores were statistically lower on days 2, 4 and 8 in the intracapsular group compared to the extracapsular cohort. The intracapsular cohort also returned sooner to normal fluid and solids intake. The extracapsular group were more likely to visit the general practitioner post-operatively.

Intracapsular tonsillectomy appears to result in reduced morbidity overall and should be considered as a viable alternative in relevant cases.