How we do it: Transoral suction diathermy adenoid ablation under direct vision using a 45 degree endoscope


Dr S. Lo, Department of Otorhinolaryngology–Facial Plastic Surgery, Royal Surrey County Hospital, Guildford GU2 5XX, UK, Tel.: +44 7786 927613; fax: +44 1483 555829; e-mail:


• Adenoid ablation using suction diathermy is associated with a number of difficulties, mainly associated with the use of the mirror. Transoral and transnasal 0 degree endoscopes have also been utilised but again have limitations. We describe a technique that overcomes the above problems.

• A prospective case series of patients undergoing suction diathermy adenoidectomy under direct vision using a transoral 45 degree endoscope connected to a monitor was conducted, performed by surgical trainees and under direct supervision of the consultant trainer (J.R.-J.).

• Intra-operatively, trainees had to demonstrate to the trainer the appropriate anatomy, completed adenoid ablation, and haemostasis.

• Fifty-six cases have been performed. In every case, it was possible for the trainer to monitor the trainee's technique throughout the entire procedure. No complications have been reported.

• We describe a modified technique which overcomes the disadvantages previously encountered by conventional suction diathermy adenoid ablation.