Eve’s Tonsillar Snare

This instrument is part of the tonsillectomy set and is used in the step of removing the dissected tonsil from its final attachment to the fossa.

Identification of the instrument

This is an easy instrument to identify. It consists of a long, thin, hollow tube with a stainless steel wire loop at one end and three large rings at the other. These three rings allow the instrument to be operated using three fingers.

How the tonsillar snare is used

The instrument is held by inserting the forefinger and the middle finger into two rings on either side of the snare. The thumb is placed in the single ring at the back. This ring is actually located at the end of the plunger. Pulling the plunger with the thumb draws out the wire loop while it can be pulled back in by pressing the plunger with the thumb.

The wire loop is first threaded over the Denis Browne tonsil holding forceps. The dissected tonsil is then held with the forceps and the wire loop moved over it until it surrounds the pedicle of the tonsil. The thumb is then pressed down to draw back the loop. The pedicle of the tonsil is both cut and crushed by this movement. Cutting and crushing the pedicle rather than just cutting it helps reduce hemorrhage.

More information:

• Earlier, snares were also used to remove nasal and aural polyps, too. The Glegg’s (avulsion) snare was used to avulse nasal polyps, while the Krause aural snare was used to remove aural polyps. These instruments are not used anymore.
• In the absence of a tonsillar snare, the pedicle can be clamped with long, curved artery forceps, cut and tied with silk.
• After the tonsil is snared out, the raw tonsillar fossa is immediately packed with gauze to achieve hemostasis.

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