Bipolar Scissors versus Cold Dissection Tonsillectomy: A Prospective, Randomized, Multi‐Unit Study

Raut, Vivek; Bhat, Nisar Ahmad; Kinsella, John; Toner, J. G.; Sinnathuray, A. R.; Stevenson, M

doi:10.1097/00005537-200112000-00020

Cited by 67 publications

(47 citation statements)

References 19 publications

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“…In bipolar electrocautery the spread of heat to the tissue and its environment is less than the monopolar where as in cold dissection method there is no spread of heat to the tissue thereby tissue damage is less. [7][8][9] In the present study 22 males and 18 females underwent tonsillectomy for recurrent tonsillitis indicating a slight preponderance for male which is in concordance with Khan AR et al study.…”

Section: Discussionsupporting

confidence: 89%

A single blind controlled study comparing bipolar elecrocautery tonsillectomy to cold dissection method in pediatric age groups

et al. 2014

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Background: Tonsillectomy is one of the most commonly performed operations in otolaryngology. There are many proven methods of tonsillectomy, including cold dissection and bipolar electrocautery. Objective: To compare bipolar elecrocautery tonsillectomy with cold dissection method in pediatric age groups. Methods: Single blind controlled study to compare bipolar technique against the conventional dissection/snare technique. Results: The average amount of bleeding on electrocautery side was 4.07ml and on the cold dissection side was 14.58 ml. The mean time of operation for electrocautery and cold dissection was 12.04 and 16.57 minutes respectively. On the second post operative day, 35% of the patients complained of pain on the cauterized side, 30% complained of more pain on the dissection side while 35 % experienced equal pain on both sides. Post-operative complication such as hemorrhage was not seen in both the techniques employed. Conclusion: In the present study, bipolar diathermy tonsillectomy had advantages in having less post-operative time and blood loss intraoperatively but patients experience slightly more pain than cold dissection.

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Section: Discussionsupporting

confidence: 89%

A single blind controlled study comparing bipolar elecrocautery tonsillectomy to cold dissection method in pediatric age groups

et al. 2014

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“…Cautery use in tonsillectomy was first defined in 1962 [3,4]. Further, Andrea defined the first microsurgical bipolar cautery technique in 1993 [5].…”

Section: Introductionmentioning

confidence: 99%

“…Especially postoperative pain in pediatric patients gives way to dehydratation and delays in oral intake, and these in turn have a negative effect on the patients' analgesic use and the period of normalization. Local/systemic analgesic use [6,7], different instruments and techniques (unipolar cautery, bipolar cautery, dissection) [1], and the recent subtotal removal of the tonsils, "tonsillotomy," (microdebrider, CO2 laser, low temperature plasma knife, radiofrequency) in selected cases are among the ways that are currently under consideration in order to solve the problem of postoperative pain [2,3,4,6].…”

Section: Introductionmentioning

confidence: 99%

The Use of Bipolar Electrocautery Tonsillectomy in Patients with Pediatric Respiratory Tract Obstruction

2012

Ann Clin Anal Med

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ÖzetAmaç: Bu çalışmada tonsiller hipertrofi nedeni ile solunum yolu obstrüksi-yonu olan çocuklarda uygulanan bipolar elektrokoter tonsillektomi ve klasik tonsillektomi tekniklerinin ameliyat sırasında ve sonrasındaki klinik sonuçları karşılaştırılmalı olarak değerlendirildi. Gereç ve Yöntem: Bipolar elektrokoter ile tonsillotomi yapılan 31 çocuk hasta ile konvansiyonel soğuk disseksiyon tonsillektomi yapılan 45 çocuk hasta karşılaştırıldı. Postoperatif ağrı skorları erken postoperatif dönemde 'Modifiye Hannalah Skalası' ile ve geç postoperatif dönemde 'Vizüel Analog Skoru' ile ölçüldü. Bu iki grup operasyon sırasındaki kan kaybı, operasyon süresi, oral alım süresi, ağrı kesici alımı, iyileşme zamanı ve postoperatif ağrı skorları açısından karşılaştırıldı. Bulgular: Bipolar elektrokoter ile tonsillotomi yapılan çocuklarda iyileşme sürecinde konvensiyonel tonsillektomi uygulanan gruba göre belirgin olarak daha az ağrı olduğu görüldü. Bipolar elektrokoter tonsillotomi yapılan grupta intraoperatif kan kaybı, operasyon süresi, oral alım süresi, ağrı kesici alımı, iyileşme süresi ve postoperatif ağrı skorları konvansiyonel tonsillektomi uygulanan gruba göre daha az olduğu tespit edildi. Sonuç: Bipolar elektrokoter tonsillotominin obstrüktif uyku apnesi olan çocukların iyileşmesinde konvansiyonel tonsillektomi ile eşit etkinlikte ve güvenirlikte olduğu görüldü. Bipolar elektrokoter tonsillotomi yöntemi ile postoperatif ağrı daha az olmakta, yaşam kalitesini arttırmakta ve iyileşme sürecini kısaltmaktadır. Bu nedenlerle bipolar elektrokoter tonsillotomi yöntemi çocuklarda konvansiyonel tonsillektomiden daha kabul edilebilir bir yöntem olabilir. Anahtar Kelimeler

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“…Electro caurtery dissection method of tonsillectomy had higher incidence of bleeding as compared to the cold dissection in our study. In the recent studies it has been observed that the reactionary and secondary hemorrhage rates were unaffected by the surgical methods used [40][41][42][43]. The overall rate of transfer the patient to operating room under general anesthesia for control of post tonsillectomy bleeding varied from 0.93 to 2.9% in the literature [44][45] and incidence of such patients was 57.1% (20/35 bleeding patients) in one of the reports [38].…”

Section: Discussionmentioning

confidence: 99%

Adult tonsillectomy and day care surgery

Verma

Nabhani

Al-Khabori

2007

Indian J Otolaryngol Head Neck S

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Objective To evaluate the safety of adult tonsillectomy as a day care surgery Methods Records of 664 patients above the age of 12 years, who underwent tonsillectomy were analysed. These patients were operated in our department within January 1999 and September 2002. Only 13 patients (1.95%) had post operative bleeding and were readmitted after discharge. The data of these patients were collected from medical records as well from the morbidity meeting proceedings and was reviewed retrospectively. Statistical analysis was done by using 'one sample t-test'.Results Overall incidence of post operative bleeding was 1.95%. None of our pateients bled with 12 hours of Surgery, 0.3 % had bleeding between 12 to 24 hours after tonsillectomy and 1.65% encountered bleeding between 24 hours to the 6th post operative day. Bleeding was not major in majority of patients as only 0.45% of the patients required second anesthesia to control the bleeding and only 0.35% of patients required blood transfusion to replace the lost blood volume. In addition, higher incidence of bleeding was seen in males, in the older age group of 31-40 years, patients with obstructive sleep aponea and in patients where tonsillectomy was done by electrocautry dissection. ConclusionBased on these observations, we conclude that Adult tonsillectomy can be safely preformed in our setup. Keyword Post operative bleedings One sample ttest Blood transfusion Tonsillectomy

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Bipolar Scissors versus Cold Dissection Tonsillectomy: A Prospective, Randomized, Multi‐Unit Study

Abstract: Bipolar scissors tonsillectomy is a safe technique with a similar morbidity to the cold dissection method. Its use is associated with a significant decrease in both surgical time and blood loss compared with the cold dissection method.

Cited by 67 publications

References 19 publications

A single blind controlled study comparing bipolar elecrocautery tonsillectomy to cold dissection method in pediatric age groups

A single blind controlled study comparing bipolar elecrocautery tonsillectomy to cold dissection method in pediatric age groups

The Use of Bipolar Electrocautery Tonsillectomy in Patients with Pediatric Respiratory Tract Obstruction

Adult tonsillectomy and day care surgery

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