A Parallel Group Analysis of Tonsillectomy Using the Harmonic Scalpel vs Electrocautery

Abstract

To evaluate efficiency and postoperative morbidity in tonsillectomy using the harmonic scalpel (HS) vs conventional electrocautery (EC). Design: A retrospective medical chart review of all patients who underwent tonsillectomy at a single children's hospital during a 32-month period from January 2001 to August 2003. Patients: The charts of 605 patients who underwent tonsillectomy or adenotonsillectomy were reviewed. The patients were stratified into 2 groups based on the dissecting instrument used (HS vs EC). Each group consisted of 2 subcategories based on age (Յ7 years and Ͼ7 years). Data collected included age, sex, operative indication, operative time, postanesthetic recovery room time, pain scale scores, postoperative admissions, and postoperative morbidities. Results: There were significant differences in mean age (PϽ.001), mean weight (PϽ.001), and indication for surgery (PϽ.001) between the 2 methods: HS patients were younger, weighed less, and more often had obstructive symptoms as their primary operative indication com

The Effect of Ultrasonic Surgery Tool in the Treatment of Tonsillolithiasis

“…Khalaf AQ et al (26) reported satisfying results in chronic tonsillitis and tonsillar hypertrophy with this surgical tool. Several studies support that ultrasonic energy decreases pain scores with the least postoperative discomfort in tonsillectomy (27,28). Similar to these ultrasound energy performed a significant decrease in patient's complaints and also helps the elimination of the tonsilloliths in our study.…”

The Effect of Ultrasonic Surgery Tool in the Treatment of Tonsillolithiasis

“…Khalaf AQ et al (26) reported satisfying results in chronic tonsillitis and tonsillar hypertrophy with this surgical tool. Several studies support that ultrasonic energy decreases pain scores with the least postoperative discomfort in tonsillectomy (27,28). Similar to these ultrasound energy performed a significant decrease in patient's complaints and also helps the elimination of the tonsilloliths in our study.…”

Harmonic Scalpel Tonsillectomy Using the Curved Shears Instrument versus Cold Dissection Tonsillectomy: A Retrospective Study

“…The range of the average length of HS tonsillectomy reported in the medical literature is from 8 minutes 10 seconds to 32 minutes 18 seconds. 10,11,[13][14][15][16]19 In this study, HS tonsillectomy using the curved shears instrument was found to be significantly faster than CD tonsillectomy and on average faster than tonsillectomies reported in any of the above-mentioned studies. Speed itself is not, of course, a primary objective, although shorter operating times (achieved without compromising other outcome measures) can be advantageous in reducing operating room costs.…”

“…Previously published studies have found HS tonsillectomy to have operating times that are the same as those of electrocoagulation (eC) tonsillectomy, 3,10,15 the same as those of CD tonsillectomy, 13,17,18 and longer than those of either CD tonsillectomy 14 or eC tonsillectomy. 16 In only 1 retrospective 3-way comparison of HS versus CD versus eC tonsillectomies was use of the HS found to be faster than the other techniques.…”

Post-tonsillectomy pain after using bipolar diathermy scissors or the harmonic scalpel: a randomised blinded study

“…In the harmonic scalpel group [ n  = 22 (8 males and 14 females)], the mean age was 20.27 years (SD 6.96; range 9–36). In the bipolar diathermy scissors group [ n  = 18 (4 males and 14 females)], the mean age was 21.83 years (SD 5.77; range 14–37).…”

“…In the bipolar diathermy scissors group [ n  = 18 (4 males and 14 females)], the mean age was 21.83 years (SD 5.77; range 14–37). There was no statistical difference between the groups for age at surgery ( p  = 0.199).…”

The Effect of Ultrasonic Surgery Tool in the Treatment of Tonsillolithiasis

“…Khalaf AQ et al (26) reported satisfying results in chronic tonsillitis and tonsillar hypertrophy with this surgical tool. Several studies support that ultrasonic energy decreases pain scores with the least postoperative discomfort in tonsillectomy (27,28). Similar to these ultrasound energy performed a significant decrease in patient's complaints and also helps the elimination of the tonsilloliths in our study.…”

Harmonic Scalpel Tonsillectomy Using the Curved Shears Instrument versus Cold Dissection Tonsillectomy: A Retrospective Study

“…The range of the average length of HS tonsillectomy reported in the medical literature is from 8 minutes 10 seconds to 32 minutes 18 seconds. 10,11,[13][14][15][16]19 In this study, HS tonsillectomy using the curved shears instrument was found to be significantly faster than CD tonsillectomy and on average faster than tonsillectomies reported in any of the above-mentioned studies. Speed itself is not, of course, a primary objective, although shorter operating times (achieved without compromising other outcome measures) can be advantageous in reducing operating room costs.…”

“…Previously published studies have found HS tonsillectomy to have operating times that are the same as those of electrocoagulation (eC) tonsillectomy, 3,10,15 the same as those of CD tonsillectomy, 13,17,18 and longer than those of either CD tonsillectomy 14 or eC tonsillectomy. 16 In only 1 retrospective 3-way comparison of HS versus CD versus eC tonsillectomies was use of the HS found to be faster than the other techniques.…”

Post-tonsillectomy pain after using bipolar diathermy scissors or the harmonic scalpel: a randomised blinded study

“…In the harmonic scalpel group [ n  = 22 (8 males and 14 females)], the mean age was 20.27 years (SD 6.96; range 9–36). In the bipolar diathermy scissors group [ n  = 18 (4 males and 14 females)], the mean age was 21.83 years (SD 5.77; range 14–37).…”

“…In the bipolar diathermy scissors group [ n  = 18 (4 males and 14 females)], the mean age was 21.83 years (SD 5.77; range 14–37). There was no statistical difference between the groups for age at surgery ( p  = 0.199).…”

The Effect of Ultrasonic Surgery Tool in the Treatment of Tonsillolithiasis

“…Khalaf AQ et al (26) reported satisfying results in chronic tonsillitis and tonsillar hypertrophy with this surgical tool. Several studies support that ultrasonic energy decreases pain scores with the least postoperative discomfort in tonsillectomy (27,28). Similar to these ultrasound energy performed a significant decrease in patient's complaints and also helps the elimination of the tonsilloliths in our study.…”

Harmonic Scalpel Tonsillectomy Using the Curved Shears Instrument versus Cold Dissection Tonsillectomy: A Retrospective Study

“…The range of the average length of HS tonsillectomy reported in the medical literature is from 8 minutes 10 seconds to 32 minutes 18 seconds. 10,11,[13][14][15][16]19 In this study, HS tonsillectomy using the curved shears instrument was found to be significantly faster than CD tonsillectomy and on average faster than tonsillectomies reported in any of the above-mentioned studies. Speed itself is not, of course, a primary objective, although shorter operating times (achieved without compromising other outcome measures) can be advantageous in reducing operating room costs.…”

“…Previously published studies have found HS tonsillectomy to have operating times that are the same as those of electrocoagulation (eC) tonsillectomy, 3,10,15 the same as those of CD tonsillectomy, 13,17,18 and longer than those of either CD tonsillectomy 14 or eC tonsillectomy. 16 In only 1 retrospective 3-way comparison of HS versus CD versus eC tonsillectomies was use of the HS found to be faster than the other techniques.…”

Post-tonsillectomy pain after using bipolar diathermy scissors or the harmonic scalpel: a randomised blinded study

“…In the harmonic scalpel group [ n  = 22 (8 males and 14 females)], the mean age was 20.27 years (SD 6.96; range 9–36). In the bipolar diathermy scissors group [ n  = 18 (4 males and 14 females)], the mean age was 21.83 years (SD 5.77; range 14–37).…”

“…In the bipolar diathermy scissors group [ n  = 18 (4 males and 14 females)], the mean age was 21.83 years (SD 5.77; range 14–37). There was no statistical difference between the groups for age at surgery ( p  = 0.199).…”