Experimental setup
A life-size, anatomically realistic model of the head (AirSim®. TruCorp®
Co. Armagh, Northern Ireland, U.K) was used in this study (Figure 1a).
All simulations of tonsil surgery were undertaken in the operating
theatre suite at [removed for blind peer review]. The hospital is a
recent construction (2015) incorporating modern airflow techniques in
each of its operating theatres. The model was placed at the top edge of
the operating table in an extended neck position, akin to the
conventional way of doing a tonsillectomy in a patient, with an
appropriately sized Boyle–Davis mouth-gag which was supported by
Draffin rods (Figure 1a). Pillows were placed at the bottom of the model
to simulate the chest and upper abdomen of a patient. The model and
surgical setup was then covered by an impervious black square sheet.
Fresh strawberries cut in half and soaked overnight in nontoxic
fluorescein dye (1mg in 25mL. Monument Tools, MAP UK (TA Tool Chimp)
Ltd. Essex, U.K) was used to simulate tonsils (Figure 1b). The
CoblationTM ProciseTM EZ wand
(Smith&Nephew Ltd. Hull, U.K) was used in default energy settings
(Coblate = 7, coagulate = 3). Diluted fluorescein dye was also added to
the irrigation bag; 1g dye diluted in 250mL irrigation fluid. (Figure
1c).
Tonsil surgery was undertaken by two trained members of the team
([removed for blind peer review]) who undertook five experiments
each, wearing standard personal protective equipment (PPE).