Tonsillectomy Instruments: A Practical Guide to the Tonsil and Adenoid Set

Contents of a tonsillectomy instrument set

A tonsillectomy tray starts with a mouth gag to hold the jaws open and expose the throat, a tongue depressor, tonsil-seizing forceps, tonsil dissectors and knives, scissors, haemostats and suction. If a snare is used, the snare and wire are added; if the adenoids are also removed, adenoidectomy instruments join the tray.

Many departments run a separate paediatric set because children's mouths and tonsils are small. Sizes of gag blades and forceps should match the patient groups your department treats.

Agree the tray list with the surgeon and anaesthetist in advance, because the airway is shared during tonsil surgery and any equipment that sits in the mouth, such as the gag blade, must fit the tube arrangement used in your hospital.

• Mouth gag with tongue blades in several sizes
• Tonsil seizing forceps and dissectors
• Tonsil knives and scissors
• Haemostats and tonsil ligature holders
• Suction tubes
• Adenoid curettes and punch forceps

Mouth gag and Boyle Davis mouth gag

The mouth gag is the most important item of the set. The Boyle-Davis mouth gag is the classic design: it has a self-retaining frame, a tongue blade with a groove for the endotracheal tube and adjustable blade sizes. The ratchet holds the jaws open while the blade depresses the tongue, giving the surgeon both hands.

REDA of Tuttlingen lists mouth gags within its ENT instruments range. Check that the gag opens evenly, that the ratchet holds under load and that different blade widths are provided for children and adults. Confirm the exact patterns with the supplier.

Tonsil dissectors, snare and haemostasis

Tonsil dissectors, seizing forceps and knives are used to free the tonsil from the fossa. REDA lists tonsil knives, dissectors and seizing forceps. Seizing forceps typically have several teeth to grip tonsil tissue securely, and should close squarely.

A tonsil snare is a wire-loop instrument used to cut the tonsil base; check with the supplier whether a particular pattern is included. Haemostasis is achieved with ties, ligature, diathermy or packs. If your surgeons use bipolar diathermy, verify the compatibility of the forceps and generator with your biomedical team, and consider the relevant IEC 60601-2-2 requirements. See also our guide to ENT instruments.

Adenoidectomy instruments

Adenoid removal uses curettes and adenotomes passed behind the soft palate. REDA's range includes Beckmann adenoid curettes, which come in several sizes so that the curette matches the patient's nasopharynx. Choose several sizes per set, and keep fine suction tubes and a mirror available.

Because the adenoid curette works partly blind, edge quality matters. A damaged or dull edge tears tissue rather than cutting it. Inspect each curette before use.

Care, planning and sourcing

Reprocess tonsil instruments promptly, because dried blood is difficult to remove. Clean suction tubes with brushes and flushing, check ratchets, and sterilize by steam following manufacturer instructions and ISO 17665 practice.

Departments performing tonsil surgery as day cases should plan enough sets for the list size. Confirm product registration with the relevant UAE authority. Beckfinity's specialists can prepare a quotation for a tonsil and adenoid set from the REDA catalogue.

Finally, keep suction tips and mouth gag blades in more than one size so that paediatric and adult lists do not require separate ordering.