Coblation (Cold ablation),  một phương pháp cắt bỏ mô mới, đđược nghiên cứu bởi đại học Miami và được thực tế hóa bởi tập đoàn ArthoCare ở Sunnyvale California Mỹ. Về nguyên tắc đây cũng là một phương pháp phẫu thuật điện lưỡng cực, dòng điện tần số radio, nên nó có đầy đủ các ưu điểm của các phương pháp dùng điện khác như phẫu thuật nhanh, ít mất máu, nhưng nó ưu việt hơn các phương pháp này ở chỗ nó dùng đầu đốt lạnh, cắt mô qua trung gian môi trường nước nên nhiệt độ cắt đốt thấp từ đó ít gây tổn thương mô lành xung quanh trong khi các phương pháp phẫu thuật điện, laser truyền thống khác sử dụng nhiệt để cắt đốt phân tử nên nhiệt độ cắt đốt khá cao (400-600°C) nên gây tổn thương khá nhiều cho các mô lành xung quanh. Mặt khác do cấu tạo của hệ thống Coblator, hệ thống hút nằm ngay trên điện cực nên phẫu thuật viên có thể vừa cắt, đốt vừa hút dịch và máu chảy ra nên càng đơn giản hóa và rút ngắn thời gian phẫu thuật

ENDOSCOPIC TRANSNASAL ADENOID ABLATION (COBLATION)                                                        Trần Anh Tuấn, Nguyễn Văn Đức, Nguyễn Hữu Khôi Coblation is a rather new electrosurgical technique that has applied to ORL surgery since 1998 in the world. This method have many high technologies such as bipolar probe systems, cool probe (Plasma Wand) with a low temperature molecular disintegration. The result is volumetric tissue removal with minimal collateral tissue necrosis. In Việt-Nam, the University Medical Center 2 is the first unit which has applied coblation to some ORL surgical procedures such as tonsillectomy, inferior turbinate interventions to treat mucosal hypertrophy, UVPP soft palate interventions for snoring and adenoidectomy. Objective : to assess the morbidity and efficacy of radiofrequency thermal ablation adenoidectomy (coblation) Study design and setting : Prospective, randomized, controlled clinical study Of 39 patients aged 1 to 15 years admitted for adenoidectomy by Coblator II system, all with recurrent or chronic adenoiditis, obstructive adenoid hypertrophy or otitis media with effusion. This operation were carried out in University Medical Center 2. All of them used a general anesthetic technique. Operative time was recorded as the number of minute frome insertion of the mouth gag to removal of the mouth gag. Estimated blood loss was recorded for each patient. After operation, all patients took antibiotics (Augmentin®) and analgesic (Efferalgan®). All patients were asked to fill out a postoperative diary. Results : Intraoperative blood loss : median 4,51ml (2-10ml; SD : 1,554); Operating time : median 11,08 minute (6-18 minute; SD : 2,63). Rate of primary bleeding need to manage : 0% (0/39). Rates of secondary bleeding after the first 24 hours postoperatively with need to manage0% (0/39). Time of return to a normal diet (as the preoperation):2,26 days (1-5, SD: 1,069). the day each patient return to work normaly : 1,31 days  (1-3; SD: 0,614) Conclusion : endoscopic transnasal adenoid ablation by coblation is a safe and effective method, with short surgery time, decrease in blood loss, less postoperative pain, faster healing and reduced home care.

OBJECTIVE: Examine changing trends/instrument usage for pediatric adenotonsillectomy. STUDY DESIGN AND SETTING: Survey of 300 members of the American Society of Pediatric Otolaryngology assessing instruments used in adenotonsillectomy currently and over the past 15 years. RESULTS: A total of 120 surveys were returned. The most common total tonsillectomy instruments for obstruction/infection were: monopolar electrocautery (ME) (53.1%/54.5%) and coblation (CT) (16.0%/16.1%). The most common subtotal tonsillectomy instrument for obstruction/infection was microdebrider (51.4%/30.8%). Over the past 15 years, ME predominated, cold utilization declined, and CT rose. The most common adenoidectomy instruments were ME (25.0%/25.0%), curette with touch-up ME (22.4%/22.4%), and microdebrider with touch-up ME (19.0%/ 14.7%). Over the past 15 years, curette with touch-up ME predominated early, curette utilization alone declined, and ME, microdebrider, and CT have risen. CONCLUSION: Pediatric otolaryngologist technique/instrument use for adenotonsillectomy has changed over the past 15 years. This study may be limited by the low survey response rate.