Gwynne Evans Tonsillar Dissector

This instrument is used in the dissection method of tonsillectomy.

The tonsillar dissector is a long and thin instrument that is used to separate the tonsil from its bed in the dissection method of tonsillectomy. While one end is flattened out like a blade, the other end is serrated.

Uses

• Tonsillectomy – The flat end is used for sharp dissection while the serrated end is used to release the connective tissue holding the tonsil to its bed.
• The serrated end is also useful in other surgeries like the removal of cysts when connective tissue has to be separated from the cyst wall.
• The instrument is also useful in separating periosteum from bone in some surgeries.

Differentiating it from other instruments:

The Freer’s elevator

This is a long, thin instrument used in septal surgeries. Both its ends are flattened out like blades. Also, it is smaller and thinner compared to the tonsil dissector.

Pillar retractor

This is an instrument that looks very similar to the tonsillar dissector. Unlike the Freer’s elevator which is noticeably small, this instrument is similar to the tonsil dissector in size and bulk. The trick is to hold the instrument and examine its ends. One end is flattened and blade like but the other end is wide and the tip is bent to form a hook. Read more about the anterior pillar retractor to learn how to identify it and to look at pictures.

More information:

• Other instruments that can be used for tonsillar dissection are Waugh’s toothed forceps and sharp dissecting scissors.
• It is important to carry out dissection in the exact plane between the tonsil and its bed – digging either into the fossa or the tonsil can cause a lot of bleeding.

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