Tonsillotomy by monopolar diathermy as a new procedure in Greenland: a feasibility study

Tonsillotomy (TT) has emerged as a less invasive alternative to tonsillectomy (TE), associated with lower bleeding risk. In Greenland, where access to ear, nose and throat specialists and emergency care is limited, postoperative bleeding is a significant concern. The objective of this study was to assess the feasibility of implementing TT across Greenland. A prospective case series was conducted at one central and two remote healthcare facilities. Children and adults with tonsillar hypertrophy, recurrent or chronic tonsillitis were eligible for inclusion. TT was performed using monopolar diathermy. Data were collected from medical records and structured interviews of patients and surgeons. Feasibility was assessed through procedure completion, logistics, patient satisfaction and surgeon feedback. Secondary outcomes included intraoperative parameters and postoperative morbidity. Ten patients underwent TT for tonsillar hypertrophy or recurrent tonsillitis. Inclusions at one facility were prevented by weather-related disruptions. Six surgeons performed the procedures without complications. Two patients were re-examined after discharge; one showed a self-limited bleeding. Patients reported overall satisfaction, and the surgeons noted only minor challenges. Implementation of TT in Greenland is feasible with the available resources. Acceptability is high and morbidity low. With guidelines and adjustments for mobile remote surgery, TT can be integrated into routine care.