"Co-" stands for "controlled" and "-blation" is from the word, "ablation," which is the process of reducing the size of something; when the sun melts an iceberg, the process is called, "ablation." COBLATION technology combines radiofrequency energy and saline to create a plasma field. The plasma field remains at a relatively low temperature as it precisely ablates the targeted tonsil tissue. The COBLATION plasma field removes target tissue while minimizing damage to surrounding areas.
A COBLATION tonsillectomy is the use of a COBLATION wand to remove the tonsils.
Surgeons and patients alike have searched for years for a better way to remove the tonsils. Because the tonsils are located in the throat, removing them with an electrosurgery device can often lead to painful damage of nearby tissue. COBLATION technology offered an alternative to high-heat electrosurgery.
Unlike the electrosurgery procedure, a COBLATION tonsillectomy generates significantly lower temperatures on contacted tissue*. This gives surgeons the ability to precisely remove targeted tonsil tissue while preserving the nearby healthy tissue.
COBLATION technology precisely removes tissue by dissolving the tonsils at the molecular level rather than rupturing or burning the cells.
COBLATION technology combines low-temperature radiofrequency energy with saline to create a plasma field. This plasma field is contained at the tip of the device and dissolves tissues molecule by molecule, resulting in a precise dissection of targeted tissue. The COBLATION process generates significantly lower temperatures on the contact tissue therefore minimizing damage to the surrounding healthy tissue.
Electrosurgery generates very high temperatures by applying high-voltage energy directly to the tissue. This high heat energy is used to rupture cells and vaporize tissue. Further, this heat energy is transferred to surrounding tissues which may cause significant damage such as burning and charring.
Airway fires are often referred to as a "never" event in the operating room - meaning they should never happen. Unfortunately, as many as 600 airway fires occur each year in the US, resulting in catastrophic patient injuries. Fires require three variables for ignition: a source (electrical instruments), flammable fuels (skin, drapes, instruments, etc.) and oxidizers (supplemental Oxygen). Unlike electrosurgery instruments, studies have shown that COBLATION technology does not provide an ignition source for airway fires.*
*Roy S, Smith LP. Device-related risk of fire in oropharyngeal surgery: a mechanical model. Am J Otolaryngol 2010;31:356-9.
No matter how statistically safe a procedure has proven to be, every surgery has risks. Post Tonsillectomy Hemorrhage (PTH) is a potentially serious complication that has been reported in literature for both adult and pediatric patients. It is reported to occur following use of COBLATION devices as well as following the use of other surgical devices and methods. Before making any surgical decision, you should speak with your doctor about any potential risks.
COBLATION wands are contraindicated for use in patients with cardiac pacemakers or other electronic device implants.
* Compared to monopolar dissection, based on analysis of eight randomized clinical trials.
Harley Jr., Earl H., John T., Mike and Hanson, Beate. Coblation Dissection Versus Monopolar Dissection - A systematic Review and Meta-Analysis. 2016; Data on file with Smith & Nephew, PN 91999 Rev A.
Woloszko, Jean, and Gilbride, Charles. Coblation Technology: Plasma Mediated Ablation for Otolaryngology Applications. Proceedings of SPIE. 2000, Vol. 3907.