A prospective multi-centre randomised controlled trial comparing PlasmaKnife with bipolar dissection tonsillectomy:...

Area of Science:

• Otolaryngology
• Surgical Technology
• Paediatric Surgery

Background:

• Tonsillectomy is a common paediatric surgical procedure.
• Minimally invasive surgical techniques are continuously being explored to improve patient outcomes.
• PlasmaKnife and bipolar electrocautery are two methods used for tonsillectomy.

Purpose of the Study:

• To clinically evaluate and compare the PlasmaKnife device with bipolar electrocautery for paediatric tonsillectomy.
• To assess patient-reported pain, recovery, and surgical outcomes.

Main Methods:

• A prospective, multi-centred, double-blinded randomised controlled trial.
• 100 paediatric patients (aged 2-16 years) undergoing tonsillectomy were recruited.
• Primary outcomes included pain scores; secondary outcomes included diet and activity resumption, analgesic use, operation time, and blood loss.

Main Results:

• PlasmaKnife tonsillectomy resulted in significantly higher throat pain at 24 hours (p=0.02).
• Patients undergoing bipolar dissection showed a trend towards faster return to normal diet and activities.
• While PlasmaKnife group used less analgesia at day 14 (p=0.03), there were more secondary bleeds (4 vs 1).

Conclusions:

• No significant advantage of PlasmaKnife over bipolar diathermy tonsillectomy was found in this study.
• PlasmaKnife demonstrated a potential for reduced analgesia use but was associated with increased pain and slower recovery.
• Further larger randomised studies are warranted to fully evaluate the PlasmaKnife's potential benefits and risks.