New Technique for Tonsil Removal Spreading in Quebec

With this new surgical intervention, only 0.29% of children return to the hospital due to complications, according to studies.

An Ontario hospital has stopped scheduled tonsil and adenoid surgeries for children under 18 this week after the death of two children. A tragic situation that usually occurs in 1 case out of 20,000. However, Quebec has been innovating with a new procedure that greatly reduces the risks of complications since the pandemic.

What happened in Ontario?
The McMaster Children’s Hospital in Ontario has suspended scheduled tonsil and adenoid surgeries for patients under 18 after two children died. One child died the day after the operation, and the second child died nine days after the procedure. The exact causes of their deaths remain unknown. The hospital announced a complete review of its pediatric program for tonsil and adenoid surgeries by external experts. Only emergency pediatric operations for tonsils and adenoids will be performed.

Have there been complications in Quebec?
Every year in Quebec, over 5000 operations are performed on children. About 5% of patients experience bleeding after the operation, sometimes requiring a return to the hospital. Most bleedings occur 7 to 10 days after the operation. “Unfortunately, tonsillectomy can result in deaths. It is rare, around 1 in 20,000,” says Dr. Sam Daniel, head of surgery at the Montreal Children’s Hospital. Less than 10 children have died from complications related to this surgery in Quebec over the past 25 years. Following the death of 6-year-old Jade El Rhaib in 2017, Coroner Steeve Poisson recommended that the Ministry of Health and Social Services allocate the necessary resources to develop and implement another tonsil removal technique.

What is this new technique?
The traditional method involves removing all tonsil tissue, including that against the muscle, which increases the risk of bleeding. The new technique, called intracapsular or partial tonsillectomy, uses a hot probe to remove the tonsil without touching the surrounding muscles. This innovative technique reduces the risk of serious complications like bleeding or death. Studies show that only 0.29% of children return to the hospital due to complications. However, there is a risk of tonsil regrowth, which may require a second intervention, although this situation is very rare.

Is the recovery the same?
This new technique also accelerates recovery, according to Dr. Luc Monette, an ENT surgeon from Gatineau. Children can have a normal diet the next morning instead of a soft and cold diet for 10 to 14 days. They can also return to school and sports five days after the operation, rather than two weeks later.

Is this option widespread in Quebec?
Dr. Daniel performed the first intervention in Quebec in 2019 at the Montreal Children’s Hospital on a 9-year-old girl. Dr. Neil Bateman from the UK, an expert in the field, was present to ensure the operation went smoothly. In the same year, Dr. Monette started using this method in Outaouais. Today, about 80% of hospitals have the necessary probes to perform the operation. Quebec is currently innovative in this field, with the most hospitals using this technique.