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Published on: November 6, 2019
Harmonic scalpel tonsillectomy versus monopolar diathermy tonsillectomy: a prospective study
Jason A Roth1, Tobias Pincock, Raymond Sacks
1Department of Otorhinolaryngology, Royal Prince Alfred Hospital, New South Wales, Australia. rothemail@gmail.com
Ear, Nose, & Throat Journal
|June 19, 2008
Summary
The ultrasonic harmonic scalpel significantly reduced intraoperative bleeding during tonsillectomy compared to monopolar diathermy. However, other outcomes like operating time and postoperative complications showed no significant differences between the two surgical methods.
Area of Science:
- Otolaryngology
- Surgical Technology
- Minimally Invasive Procedures
Background:
- Tonsillectomy is a common surgical procedure.
- The ultrasonic harmonic scalpel is a newer technology for tissue dissection and hemostasis.
- Previous studies suggest potential benefits of harmonic scalpel tonsillectomy.
Purpose of the Study:
- To prospectively compare the outcomes of tonsillectomy using an ultrasonic harmonic scalpel versus monopolar diathermy.
- To evaluate differences in intraoperative bleeding, operating time, and postoperative morbidity.
Main Methods:
- Prospective study comparing 162 harmonic scalpel tonsillectomies with 40 monopolar diathermy tonsillectomies.
- Data collected over a 33-month period.
- Outcomes assessed included intraoperative blood loss, operating time, postoperative complications, and recovery time.
Main Results:
- Harmonic scalpel group had significantly less intraoperative bleeding (5.0 ml vs. 16.5 ml; p < 0.0001).
- No significant differences were observed in operating time, postoperative nausea/vomiting, dysphonia, or primary/secondary bleeding.
- Resumption of normal diet and activities was similar between groups.
Conclusions:
- The ultrasonic harmonic scalpel offers a significant advantage in reducing intraoperative bleeding during tonsillectomy.
- Despite reduced bleeding, the harmonic scalpel does not appear to offer significant advantages over monopolar diathermy regarding operating time or postoperative recovery.
- Further research may explore long-term outcomes and cost-effectiveness.
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Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...