Tonsillectomy & Adenoidectomy Instruments

🛠️ Instruments Used in Tonsillectomy and Adenoidectomy

In this post, we’ll discuss the important instruments used in tonsillectomy and adenoidectomy, focusing on:

• Identification
• Appearance
• Uses
• Viva points and precautions

This topic is high yield for practical exams and instrument spotting.

1️⃣ Boyle & Davis Mouth Gag

Identification

• A self retaining mouth gag

• Consists of two parts:

  • Boyle’s blade (interchangeable sizes based on age)
  • Davis’s gag with ratchet mechanism

How is the Boyle & Davis mouth gag used in Tonsillectomy procedure?

Uses

• Tonsillectomy (Dissection and snare method)
• Adenoidectomy
• Oral and oropharyngeal surgeries
• Palatal surgeries (cleft palate repair)
• Craniovertebral junction surgeries

What are the Advantages of Boyle & Davis mouth gag?

What precautions should you take while using Boyle & Davis mouth gag?

2️⃣ Draffin’s Bipods and Magauren's Plate

Identification

• Metallic bipod stand with multiple rings
• Magauren's plate used as base support

Description

• Bipods attach to Boyle & Davis mouth gag
• Lower ends fixed into Magauren's plate
• Maintains neck extension (Rose’s position)

What is Rose's position?

Uses

• Fixes mouth gag securely
• Maintains exposure during:
  • Tonsillectomy
  • Adenoidectomy
  • Oral, oropharyngeal, nasopharyngeal surgeries

3️⃣ St. Clair Thompson Adenoid Curette

Identification

• Available in two types:
  • With cage
  • Without cage

Describe how you will use the St. Clair Thompson Adenoid Curette while performing Adenoidectomy?

Uses

• Primary instrument for adenoidectomy

When do you use the St. Clair Thompson Adenoid Curette with cage and without cage? What is the purpose of each?

What precautions should you take while using St. Clair Thompson Adenoid Curette?

4️⃣ Denis Browne Tonsil Holding Forceps

Identification

• Angular forceps
• Atraumatic blunt jaws

Description

• Resembles Luc’s forceps but:
  • Jaws are blunt
  • No cutting edges

Uses

• Hold tonsil at upper pole & pull tonsil medially during dissection

What is the advantage of Denis Browne Tonsil Holding Forceps?

5️⃣ Waugh's Tonsil Dissecting Forceps

Identification

• Spring joint forceps
• Interlocking dissecting tips

Uses

• Incision between tonsil and anterior pillar
• Dissection from upper to lower pole
• Can hold swab for pressure over bleeding points

6️⃣ Mollison Tonsillar Dissector and Pillar Retractor

Identification

• Double ended instrument

Uses

• Dissector end (rounded)

  • Blunt dissection of tonsil from tonsillar fossa
  • Define plane between tonsil and superior constrictor

• Retractor end (broad, curved)

  • Retract anterior pillar
  • Check for bleeding points
  • Look for tonsillar tags or retained gauze

7️⃣ Eve’s Tonsillar Snare

Identification

• Long cylindrical instrument
• Stainless steel wire loop
• Sliding mechanism with finger rings

What is the size of the wire loop in Eve’s Tonsillar Snare?

Uses

• Snaring and removal of tonsil at lower pole

Describe how Eve's tonsillar snare is used during Tonsillectomy?

What is the mechanism by which Eve’s Tonsillar Snare works?

What amount of blood loss is normal during Tonsillectomy?

8️⃣ Negus Tonsil Artery Forceps

Identification

• Long, slender hemostatic forceps
• Curved blunt jaws
• Fine transverse serrations

Uses

• Clamps bleeding vessels in tonsillar fossa
• Prevents slippage and tissue trauma

9️⃣ Negus Ligature Slipper and Knot Tier

Identification

• Long rod-like instrument
• Forked distal end with central groove

Uses

• Guides ligature over artery forceps
• Facilitates secure vessel ligation

Describe how Negus Ligature Slipper and Knot Tier is used during Tonsillectomy.

🔟 Yankauer Suction Cannula

Identification

• Curved metal tube

• Rounded tip with:

  • One central opening
  • Multiple side holes

Uses

• Suction of blood and secretions during:

  • Tonsillectomy
  • Adenoidectomy
  • Palatal surgeries
  • Airway procedures

Advantages

• Rounded atraumatic tip
• Curved shape avoids visual obstruction
• Long length keeps surgeon’s hand away
• Multiple holes prevent blockage

📌 Tonsillectomy and Adenoidectomy Instruments - Summary Table