The utility of common surgical instruments for pediatric adenotonsillectomy

Thottam, Prasad John; Christenson, Jennifer R.; Cohen, David S.; Metz, Christopher M.; Saraiya, Sonal; Haupert, Michael

doi:10.1002/lary.24830

Cited by 29 publications

(23 citation statements)

References 19 publications

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“…21 In comparison, a retrospective chart analysis of 1280 paediatric patients with adenotonsillectomy showed the significantly faster surgical time for monopolar electrocautery versus the PEAK PlasmaBlade™ and radiofrequency ablation and insignificant differences in postoperative haemorrhaging. 22 However, the same study found average overall procedural costs for the PEAK PlasmaBlade™ to be more than eight times as high as for monopolar electrocautery ($30.04 vs $246.95). 22 A randomised controlled trial comparing four different energy-based tissue dissection techniques for abdominoplasty calculated much higher costs for the PEAK PlasmaBlade™, with no significant differences in wound-healing complications and drainage quantity.…”

Section: Discussionmentioning

confidence: 94%

“…22 However, the same study found average overall procedural costs for the PEAK PlasmaBlade™ to be more than eight times as high as for monopolar electrocautery ($30.04 vs $246.95). 22 A randomised controlled trial comparing four different energy-based tissue dissection techniques for abdominoplasty calculated much higher costs for the PEAK PlasmaBlade™, with no significant differences in wound-healing complications and drainage quantity. 23 In contrast, Kypta et al found significantly reduced procedure times and hospital stays for the PEAK PlasmaBlade™, as well as a cost savings of approximately €120 per patient in a retrospective analysis of techniques used for cardiovascular device replacement.…”

Section: Discussionmentioning

confidence: 94%

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Bilateral reduction mammaplasty with pulsed electron avalanche knife PlasmaBlade™ and conventional electrosurgical surgery: A retrospective, randomised controlled clinical trial

Schlosshauer

Kiehlmann

Rothenberger

et al. 2020

International Wound Journal

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Wound‐healing disorders are common complications in bilateral reduction mammaplasty. Traditional electrosurgical devices generate large amounts of thermal energy, often causing extensive thermal‐related collateral tissue damage. This study aimed to retrospectively analyse the operative performance of a novel low‐thermal plasma dissection device (pulsed electron avalanche knife—PEAK PlasmaBlade™) compared with traditional electrosurgery. Twenty patients with breast hypertrophy were randomly treated with PEAK PlasmaBlade™ on one breast and conventional electrosurgery on the other. Primary outcome measures were resection weight, drain duration, total drainage volume, and drain output on the first postoperative day. Breasts treated with PEAK PlasmaBlade™ had significantly higher resection weights (728.0 ± 460.1 g vs 661.6 ± 463.4 g; P = .038), significantly lower drain output on the first postoperative day (15.9 ± 15.2 mL vs 27.6 ± 23.5 mL; P = .023), and significantly lower drain durations (2.8 ± 1.0 days vs 3.3 ± 1.0 days; P = .030). Mean total drainage volume was lower where breast reduction was performed with PEAK PlasmaBlade™, but this difference was not significant. No major complications occurred, but wound‐healing disorders were documented in almost one‐third of the patients (35.0%, n = 7). The PEAK PlasmaBlade™ seems to be superior to conventional electrosurgery for bilateral reduction mammaplasty in terms of tissue damage and wound healing.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

Bilateral reduction mammaplasty with pulsed electron avalanche knife PlasmaBlade™ and conventional electrosurgical surgery: A retrospective, randomised controlled clinical trial

Schlosshauer

Kiehlmann

Rothenberger

et al. 2020

International Wound Journal

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“…This has been done in other studies showing a large variation in direct costs between different health care facilities, depending on numerous factors [12, 25]. In one study, the cost of using radiofrequency was 8 times higher than for monopolar cautery in pediatric adenotonsillectomy [26]. Also, coblation tonsillectomy has been shown to be considerably more expensive than electrocautery due to high costs for disposables, despite a shorter time in the operating theatre [27] .This important aspect needs further analysis, especially since tonsillotomy is usually performed with more expensive surgical methods than tonsillectomy [28].…”

Section: Discussionmentioning

confidence: 95%

Indirect costs related to caregivers’ absence from work after paediatric tonsil surgery

Gudnadottir

Tennvall

Stalfors

et al. 2017

Eur Arch Otorhinolaryngol

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Tonsillotomy has gradually replaced tonsillectomy as the surgical method of choice in children with upper airway obstruction during sleep, because of less postoperative pain and a shorter recovery time. The aim of this study was to examine the costs related to caregivers’ absenteeism from work after tonsillectomy (TE) and tonsillotomy (TT). All tonsillectomies and tonsillotomies in Sweden due to upper airway obstruction during 1 year, reported to the National Tonsil Surgery Register in children aged 1–11 were included, n = 4534. The number of days the child needed analgesics after surgery was used as a proxy to estimate the number of work days lost for the caregiver. Data from the Social Insurance Agency (Försäkringskassan) regarding the days the parents received temporary parental benefits in the month following surgery were also analysed. The indirect costs due to the caregivers’ absenteeism after tonsillectomy vs tonsillotomy were calculated, using the human capital method. The patient-reported use of postoperative analgesic use was 77% (n = 3510). Data from the Social Insurance Agency were gathered for all 4534 children. The mean duration of analgesic treatment was 4.6 days (indirect cost of EUR 747). The mean number of days with parental benefits was 2.9 (EUR 667). The indirect cost of tonsillectomy was 61% higher than that of tonsillotomy (EUR 1010 vs EUR 629). The results show that the choice of surgical method affects the indirect costs, favouring the use of tonsillotomy over tonsillectomy for the treatment of children with SDB, due to less postoperative pain.

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“…Use of low-temperature pulsed radiofrequency energy has been developed for efficient tissue dissection with minimal thermal damage. [4][5][6][7][8][9] The goal was to compare pain scores during the 14-day postoperative period. To our knowledge, there are no known published prospective clinical trials of the PEAK PlasmaBlade on pain outcomes in pediatric patients undergoing adenotonsillectomy.…”

Section: Introductionmentioning

confidence: 99%

“…To our knowledge, there are no known published prospective clinical trials of the PEAK PlasmaBlade on pain outcomes in pediatric patients undergoing adenotonsillectomy. 9,10 Patients and Methods…”

Section: Introductionmentioning

confidence: 99%

Postoperative Pain and 14-Day Recovery in Children Undergoing Adenotonsillectomy: Low Thermal Damage Device Versus Electrosurgery

et al. 2019

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This was a randomized controlled trial of low thermal damage device versus traditional electrosurgery in children 3 to 17 years old with a clinical diagnosis of sleep disordered breathing, obstructive sleep apnea with adenotonsillar hypertrophy, or recurrent adenotonsillitis. Pain score (Wong-Baker FACES pain scale) was recorded each morning before eating, drinking, or administering pain medication for 14 days postoperatively. Seventy-five children were enrolled. There was no difference in the rate of decrease in pain scores. A significant interaction between rate of pain decrease and number of pain medication doses was present (P < .0001). Median number of pain medication doses was greater with electrosurgery (36, range: 7-49) versus low thermal device (21, range: 2-124; P ¼ .001). Pain scores reached 0 after a median of 7 days (95% confidence interval [CI], 5.2-8.6) for low thermal device and 9 days (95% CI, 8.0-10.0) for electrosurgery (P ¼ .67). One child randomized to electrosurgery was withdrawn due to hospitalization for postoperative bleed. In children, low thermal device results in significantly less pain medication used during the postoperative period than electrosurgery.

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The utility of common surgical instruments for pediatric adenotonsillectomy

Abstract: 4.

Cited by 29 publications

References 19 publications

Bilateral reduction mammaplasty with pulsed electron avalanche knife PlasmaBlade™ and conventional electrosurgical surgery: A retrospective, randomised controlled clinical trial

Bilateral reduction mammaplasty with pulsed electron avalanche knife PlasmaBlade™ and conventional electrosurgical surgery: A retrospective, randomised controlled clinical trial

Indirect costs related to caregivers’ absence from work after paediatric tonsil surgery

Postoperative Pain and 14-Day Recovery in Children Undergoing Adenotonsillectomy: Low Thermal Damage Device Versus Electrosurgery

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