The learning curve of BiZact™ tonsillectomy

Dulku, Kiren; Toll, Edward; Kwun, Jin; Meer, Graeme van der

doi:10.1016/j.ijporl.2022.111155

Cited by 8 publications

(8 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Full‐text review of these 624 articles was conducted and a total of 71 articles were selected for inclusion (Figure 1). 5,6,8,16‐82 Critical appraisal of studies indicated an acceptably low risk of bias for the majority of included studies (Figure 2A and B). Potential sources of bias were most pronounced in the blinding of participants and personnel, and outcomes in the randomized studies.…”

Section: Resultsmentioning

confidence: 99%

The Impact of Surgical Indication on Posttonsillectomy Hemorrhage: A Systematic Review and Meta‐Analysis

Gutiérrez

Shannon

Nguyen

et al. 2023

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

ObjectiveTo investigate the impact of the surgical indication on posttonsillectomy bleed rates.Data SourcesPubMed, Scopus, CINAHL.Review MethodsA systematic review was performed searching for articles published from the date of inception to July 6, 2022. English language articles describing posttonsillectomy hemorrhage rates in pediatric patients (age ≤ 18) stratified by indication were selected for inclusion. A meta‐analysis of proportions with comparison (Δ) of weighted proportions was conducted. All studies were assessed for risk of bias.ResultsA total of 72 articles with 173,970 patients were selected for inclusion. The most common indications were chronic/recurrent tonsillitis (CT/RT), obstructive sleep apnea/sleep‐disordered breathing (OSA/SDB), and adenotonsillar hypertrophy (ATH). Posttonsillectomy hemorrhage rates for CT/RT, OSA/SDB, and ATH were 3.57%, 3.69%, and 2.72%, respectively. Patients operated on for a combination of CT/RT and OSA/SDB had a bleed rate of 5.99% which was significantly higher than those operated on for CT/RT alone (Δ2.42%, p = .0006), OSA/SDB alone (Δ2.30%, p = .0016), and ATH alone (Δ3.27%, p < .0001). Additionally, those operated on for a combination of ATH and CT/RT had a hemorrhage rate of 6.93%, significantly higher than those operated on for CT/RT alone (Δ3.36%, p = .0003), OSA/SDB alone (Δ3.01%, p = .0014), and ATH alone (Δ3.98%, p < .0001).ConclusionPatients operated on for multiple indications had significantly higher rates of posttonsillectomy hemorrhage than those operated on for a single surgical indication. Better documentation of patients with multiple indications would help further characterize the magnitude of the compounding effect described here.

show abstract

Section: Resultsmentioning

confidence: 99%

The Impact of Surgical Indication on Posttonsillectomy Hemorrhage: A Systematic Review and Meta‐Analysis

Gutiérrez

Shannon

Nguyen

et al. 2023

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

show abstract

“…Similarly, the learning curve with BiZact™ tonsillectomy has also identified that a more experienced fellow had a shorter operating time (less than 10 min) compared to a trainee. 22 This study found a secondary PTH rate of 5.8% but did not attempt to investigate potential differences in PTH rates between surgeon experience, noting that it was a study with small patient numbers (n = 51) and comparison was only between one trainee and one fellow.…”

Section: Discussionmentioning

confidence: 95%

BiZact™ tonsillectomy: Predictive factors for post‐tonsillectomy haemorrhage from a 1717 case series

Mao

Woods

Athanasiadis

et al. 2023

Clinical Otolaryngology

View full text Add to dashboard Cite

Objective: To determine primary and secondary post-tonsillectomy haemorrhage (PTH) rates and identify predictive factors in a cohort of consecutive adult and paediatric BiZact™ tonsillectomy cases. Setting: Retrospective cohort study. Patients from Flinders Medical Centre, Noarlunga Hospital and private otolaryngology practices who underwent BiZact™ tonsillectomy from 2017 to 2020. Data collected: patient age, indication for tonsillectomy, surgeon experience, time and severity of PTH, including return to theatre. Each secondary PTH was graded using the Stammberger classification. Logistic regression was utilised to identify predictors of secondary PTH.Results: One thousand seven hundred and seventeen patient medical records were assessed (658 adults and 1059 children). The primary PTH rate was 0.1%, and secondary PTH rate was 5.9%. The majority of secondary PTH cases were Stammberger grade A (80/102, 78.4%) requiring observation only. Few secondary PTH required medical intervention (grade B; 9/102, 8.8%), return to theatre (grade C; 12/102, 11.8%), or blood transfusion (grade D; 1/102, 1.0%), with no death reported (grade E; 0/102, 0.0%). Recurrent secondary PTH occurred in 8 patients (0.5%). Predictive factors of secondary PTH in children were surgeon experience with trainees having greater chance of PTH (OR 2.502, 95% CI 1.345-4.654; p = .004) and age of child (OR 1.095, 95% CI 1.025-1.170; p = .007). Surgeon experience was a predictive factor for adults (OR 3.804, 95% CI 2.139-6.674; p < .001).Conclusions: BiZact™ tonsillectomy has a low primary PTH rate, with a secondary PTH rate comparable to other 'hot tonsillectomy' techniques. The majority of PTH events were minor and self-reported. There appears to be a learning curve for trainee surgeons.

show abstract

“…This device received its regulatory approval in 2016 and so far, there are few studies investigating the use of the BiZact™ device in paediatric tonsillectomies. [11][12][13][14] Similar devices like the Ligasure Vessel Sealing System (LVSS) (Valleylab, Boulder, CO) and the bipolar BiClamp electrosurgical system (Erbe BiClamp 150; Erbe, Tübingen, Germany) have already shown a reduction in operative time, intraoperative blood loss and postoperative pain. 15,16 The BiZact™ tonsillectomy device consists of a handpiece with a 12 cm shaft and curved jaws at the tip.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of BiZact™ tonsillectomy versus cold steel dissection technique in adults: Analysis of operating time, intraoperative blood loss, postoperative bleeding rate and pain

Falz,

von Lücken,

Münscher

et al. 2024

Clinical Otolaryngology

View full text Add to dashboard Cite

ObjectivesTo analyse operating time, intraoperative blood loss, postoperative bleeding rate and pain when using the relatively new BiZact™ tonsillectomy device compared to the commonly used cold steel dissection technique with bipolar cautery in adults.DesignRetrospective case control study. Parameters analysed for significant association with technique were operating time, intraoperative blood loss, wound pain on postoperative days 1–4 and rate of post‐tonsillectomy bleeding (PTB).SettingMonocentric study at a department of otolaryngology and head and neck surgery at a tertiary centre in Germany.ParticipantsA total of 183 patients who underwent a bilateral tonsillectomy with either the BiZact™ tonsillectomy device or the cold dissection technique with bipolar cautery for haemostasis.Main Outcome MeasuresOperating time, intraoperative blood loss, postoperative pain on the first to fourth postoperative day (numeric rating scale: 0–10) (PTB, primary bleeding ≤24 h, secondary bleeding >24 h postoperative; Stammberger scale).Results and ConclusionThe BiZact™ tonsillectomy device leads to a significant shorter operating time with less intraoperative blood loss compared to cold steel dissection with bipolar haemostasis. No benefits with regards to PTB or postoperative pain could be observed. The use of the BiZact™ device provides major benefits in clinical routine and stands up to conventional tonsillectomy techniques.

show abstract

The learning curve of BiZact™ tonsillectomy

Cited by 8 publications

References 9 publications

The Impact of Surgical Indication on Posttonsillectomy Hemorrhage: A Systematic Review and Meta‐Analysis

The Impact of Surgical Indication on Posttonsillectomy Hemorrhage: A Systematic Review and Meta‐Analysis

BiZact™ tonsillectomy: Predictive factors for post‐tonsillectomy haemorrhage from a 1717 case series

A comparative study of BiZact™ tonsillectomy versus cold steel dissection technique in adults: Analysis of operating time, intraoperative blood loss, postoperative bleeding rate and pain

Contact Info

Product

Resources

About