Harmonic scalpel tonsillectomy versus monopolar diathermy tonsillectomy: a prospective study.
For tonsillectomy, the ultrasonic harmonic scalpel has been purported to cause less tissue injury and postoperative morbidity while providing adequate levels of hemostasis. We undertook a prospective study to compare outcomes in 162 patients who had undergone harmonic scalpel tonsillectomy and 40 patients who had undergone monopolar diathermy tonsillectomy over a 33-month period. We found that patients in the harmonic scalpel group experienced significantly less intraoperative bleeding (5.0 vs. 16.5 ml; p < 0.0001). There was no clinically significant difference between the groups with respect to (1) the amount of operating time, (2) the incidence of postoperative nausea and vomiting, dysphonia, and primary or secondary bleeding, and (3) the amount of time patients needed to resume normal diet and activities.
Department of Otorhinolaryngology, Royal Prince Alfred Hospital, New South Wales, Australia. rothemail@gmail.com
Jason A
JA
Roth
Tobias
T
Pincock
Raymond
R
Sacks
Martin
M
Forer
Neil
N
Boustred
William
W
Johnston
Michael
M
Bailey
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000503:physiopathology* / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D004564:Electrocoagulation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology*; D017060:Patient Satisfaction; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D013525:Surgical Instruments; D014068:Tonsillectomy / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome