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Ear Nose and Throat, Surrey and Sussex
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SASH - Safer Surgery

Surrey and Sussex Healthcare NHS Trust - Our six steps to safer surgery

SASH - Safer Surgery

Mr Khemani and his team use the safer surgery checklist. This is an expansion of the World Health Organisation (WHO) Surgical Safety Checklist launched in June 2008. The checklist is a tool to improve the preoperative safety for patients and reduce the risk of complications. Mr Khemani was involved in developing additional safety checks in his NHS practice.
 

 

Coblation Total Intracapsular Tonsillectomy (Case One)

Coblation Total Intracapsular Tonsillectomy (Tonsillotomy) is a novel technique for removing the tonsils without breaching the fibrous capsule of the tonsils. This means that the underlying muscle is not exposed.

The benefits of this form of surgery compared to conventional (extracapsular) tonsil surgery are:

1.) Less bleeding (haemorrhage) risk (0.2% compared to 2-5%)
2). Much faster recovery (3-7 days compared to approximately 14 days)
3). Less pain facilitating quicker discharge from hospital and reducing need for stronger pain medicines.

Coblation uses a controlled, non-heat driven process using radiofrequency energy to produce precisely focused plasma from saline. The plasma can break molecular bonds within tissue allowing it to dissolve away at relatively low temperatures (typically around 40C).

 

 

 

Adenoidectomy

Coblation Adenoidectomy is a rapid and low risk procedure for removal of adenoidal tissue.
Adenoidectomy is performed for the treatment of obstructive airway symptoms (often in association with tonsillectomy) or as an adjunct to the treatment of glue ear when accompanied by the insertion of grommets.

The benefits of this form of surgery compared to conventional procedures are:
1.) Less bleeding (haemorrhage) risk (close to 0%)
2). Much faster recovery and less pain

Coblation Total Intracapsular Tonsillectomy (Case Two)

 

 

 

Extracapsular tonsillectomy

Mr Khemani has performed more than 750 extracapsular coblation tonsillectomies. A number of studies suggest that there is less discomfort after tonsillectomy using this method and in experienced hands there is no difference in complication rate when compared to other conventional extracapsular surgical techniques. Over the last few years, he is using this technique less frequently due to the inherent benefits of the intracapsular approach (see above).
 

 

 

Stapedectomy

Stapedectomy is a form ear surgery that can be performed to treat hearing loss caused by a problem called otosclerosis. Otosclerosis causes a buildup of bone around the stapes bone within the middle part of the ear. The build-up of bone keeps the stapes from moving normally, resulting in a type of hearing loss called conductive hearing loss. The surgery is performed to replace the stapes with an artificial part. After the surgery, sound can again be transmitted from the eardrum to the inner ear. Surgery can successfully restore normal hearing in more than 90% of cases.
 

 

 

What to expect when you come in for surgery

What to expect when you come in for surgery.

Bringing in your child for surgery can be a worrying time for most parents. Making sure your child is aware of what to expect can help them feel much more relaxed. This video for children helps to explain what happens in hospital when they come in for surgery with Mr Khemani.
 

 

 

What is glue ear and how is it treated

What is glue ear and how is it treated

Glue ear is a common condition in children, usually resulting in hearing loss. This video explains what glue ear is and how it is commonly treated.
 

 

 

Understanding Eustachian Tube Dysfunction

Understanding Eustachian Tube Dysfunction

Approximately 1% of the population suffer with pressure symptoms in their ears. For some people this is only troublesome when flying, due to an inability to equalise the pressures within their middle ears as the flight descends. However, for others it can cause problems at other times, particularly after a cold or sinusitis, when it can be associated with hearing problems, ear popping, crackling or tinnitus.
 

 

 

This video shows Mr Khemani performing the Eustachian Tube Balloon Dilatation procedure

Eustachian Tube Dilatation

 

 

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