scholarly journals Conventional Dissection and Bipolar Electrocauterization Methods of Tonsillectomy: A Comparative Study

2022 ◽  
Vol 19 (1) ◽  
pp. 77-80
Author(s):  
Anshu Sharma ◽  
Shama Bhandari ◽  
Dhundi Raj Paudel

Introduction: Tonsillectomy is frequently performed surgical procedure. There are several different methods with varied advantages and disadvantages. In spite of the different techniques available there is no consensus and definite evidence for best method. The most commonly performed are conventional dissection and bipolar electrocauterization methods. Aims: The aim of the study was to compare time required for the completion of surgery, intraoperative and postoperative blood loss along with post operative pain between conventional dissection and bipolar electrocauterization methods. Methods: This comparative study was conducted from August 2019 to March 2021 in total of 30 patients planned for tonsillectomy in department of Otorhinolaryngology, Nepalgunj Medical College Teaching Hospital.In every patient right side tonsillectomy was done with conventional dissection method and left side tonsillectomy was done with bipolar electrocauterization method. Results: The mean age was 27.2±13.08 years. The mean duration of surgery was 16.53 ± 2.43 min and 11.10 ± 1.93 min in conventional dissection method and bipolar electrocauterization method respectively. The difference was statistically significant. Intraoperative blood loss was significantly lower in bipolar electrocauterization method with mean intraoperative blood loss of 19 ±4.62 ml in bipolar electrocauterization group and 81.83 ±36.54 ml in conventional dissection method. The pain intensity was statistically similar in both methods at all-time intervals post operatively. Conclusion: In tonsillectomy, bipolar electrocauterization method has advantage over conventional dissection method in regards to reduced surgical time and intra operative blood loss, without any significant difference in post-operative pain intensity and post-operative hemorrhage.

2021 ◽  
Vol 8 (41) ◽  
pp. 3559-3566
Author(s):  
Abdul Salam R. T. ◽  
Shahul Hameed A. ◽  
Meera Rajan

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications


2021 ◽  
Author(s):  
Pei-Chi Wu ◽  
Bor-Ching Sheu ◽  
Kuan-Ju Huang ◽  
Su-Cheng Huang ◽  
Wen-Chun Chang

Abstract We aim to evaluate the surgical outcome of laparoendoscopic two-site myomectomy (LETS-M). The medical records of 204 women receiving LETS-M in a tertiary referral center, including 183 surgeries performed by the experienced surgeon and 21 surgeries performed by 3 well-supervised trainees were retrospectively reviewed. The age of the participants was 39.3±6.4 years. The mean diameter of the largest myoma was 8.5±2.2 cm. The mean weight of the myomas was 281.1±183.1 g. The operation time was 97.6±40.2 min, and the intraoperative blood loss was 99.3±115.2 mL. There were 3 (1%) cases of excessive blood loss (more than 500 mL) and 2 (1%) of postoperative hematoma. The only significant difference between the experienced surgeon and trainees was the operation time (92.3±32.2 min vs. 141.2±54 min, p<.001), while the myoma number, myoma diameter, myoma weight, and intraoperative blood loss were not significantly different. The operation time did not differ among different myoma locations. In multivariate analysis, virginity, myoma number, more than 2 large myomas, and myoma size were independent variables for longer operation times. No patient experienced any major complications. The result revealed that LETS-M is a minimally invasive surgical method that is safe, effective, and easy to learn for managing uterine myoma.


2015 ◽  
Vol 9 (9-10) ◽  
pp. 626 ◽  
Author(s):  
Nathan Y. Hoy ◽  
Stephan Van Zyl ◽  
Blair A. St. Martin

Introduction: Robotic-assisted simple prostatectomy (RASP) has been touted as an alternative to open simple prostatectomy (OSP) to treat large gland benign prostatic hyperplasia. Our study assesses our institution’s experience with RASP and reviews the literature.Methods: We performed a retrospective chart review from January 2011 to November 2013 of all patients undergoing RASP and OSP. Operative and 90-day outcomes, including operation time, intraoperative blood loss, length of hospital stay (LOS), transfusion requirements, and complication rates, were assessed.Results: Thirty-two patients were identified: 4 undergoing RASP and 28 undergoing OSP. There was no difference in mean age at surgery (69.3 vs. 75.2 years; p = 0.17), mean Charlson Comorbidity Index (2.5 vs. 3.5; p = 0.19), and mean prostate volume on TRUS (239 vs. 180 mL; p = 0.09) in the robotic and open groups, respectively. There was a significant difference in the mean length of operation, with RASP exceeding OSP (161 vs. 79 min; p = 0.008). The mean intraoperative blood loss was significantly higher in the open group (835.7 vs. 218.8 mL; p = 0.0001). Mean LOS was shorter in the RASP group (2.3 vs. 5.5 days; p = 0.0001). No significant differences were noted in the 90-day transfusion rate (p = 0.13), or overall complication rate at 0% with RASP vs. 57.1% with OSP (p = 0.10).Conclusions: Our data suggest RASP has a shorter LOS and lower intraoperative volume of blood loss, with the disadvantage of a longer operating time, compared to OSP. It is a feasible technique and deserves further investigation and consideration at Canadian centres performing robotic prostatectomies.


2019 ◽  
Vol 17 (01) ◽  
pp. 71-75
Author(s):  
Mukesh Kumar Sah ◽  
Yogesh Neupane ◽  
Rajendra Prasad Guragain

Background: Intraoperative bleeding and postoperative pain are two commonest concerns for both patient and surgeon in tonsillectomy. This study was aimed to compare intraoperative blood loss and early postoperative pain between ultrasonic device and bipolar diathermy tonsillectomy in children.Methods: Prospective, interventional, single blinded, comparative study was carried out from September 2016 to September 2017 including children up to age 15 years who underwent tonsillectomy either by bipolar diathermy or ultrasonic device. Intraoperative blood loss was recorded using standard sized gauge technique. Post-tonsillectomy pain on first five postoperative days (early postoperative pain) was assessed using Visual analog scale for children older than 5 years and FLACC score for children up to 5 years respectively.Means were compared.Results: 38 children (76 tonsils) were included in the study out of which 31 were boys (62 tonsils) and 7 were girls (14 tonsils). The mean intraoperative blood loss in ultrasonic dissection group was 13.94 ml and 13.91 ml in bipolar diathermy group. This difference was not statistically significant (p=0.974). Post-operative pain on 1st, 2nd, 3rd and 4th days were significantly less (p<0.05) in ultrasonic device group compared to bipolar diathermy group. Post-operative pain was less also on 5th post-operative day in ultrasonic device but was not statistically significant (p=0.172).Conclusions: Tonsillectomy in children using ultrasonic device did not differ from bipolar diathermy tonsillectomy in respect to intraoperative blood loss. However, early postoperative pain was significantly lower in ultrasonic device group.Keywords: Bipolar diathermy; tonsillectomy; ultrasonic device.


2017 ◽  
Vol 36 (04) ◽  
pp. 207-212
Author(s):  
Flávio Romero ◽  
Rodolfo Vieira ◽  
Bruno Ancheschi

Purpose To compare the efficacy and safety of the percutaneous screw fixation (PSF) and the open pedicle screw fixation (OPSF) on thoracolumbar (TL) fracture. Methods Sixty-four adult patients with TL vertebral fractures who underwent open or percutaneous posterior short-segment transpedicular screw fixation between January of 2013 and September of 2015 were retrospectively reviewed. All patients underwent clinical, radiological and quality of life follow-up for at least 18 months. Results There was no significant difference in age, gender, time between injury and surgery, and preoperative percentage of anterior column height, preoperative sagittal regional Cobb angle, or kyphotic angle of fractured vertebra between these two groups (p > 0.05). There was significantly less intraoperative blood loss in the PSF (87.6 ± 24.6 mL) than in the OPSF group (271.4 ± 142.6 mL) (p < 0.05). The mean surgery time was 62 minutes (range 42–130 minutes) for open and 58 minutes (range 35 to 128 minutes) for percutaneous screw fixation. The surgery time was shorter in the PSF group, but with no statistical significance (p > 0.05). The mean Oswestry disability index (ODI) scores after 18-months were 23.12 ± 8.2 for the PSF and 24.12 ± 9.2 for the OPSF group, without any statistical significance (p > 0.05). Conclusion Both open and percutaneous screw fixations are safe and effective. The percutaneous techniques significantly reduced the intraoperative blood loss compared with the open techniques.


2021 ◽  
Author(s):  
Ameer A. Alaqeedy ◽  
Rasheed Ali Rashid ◽  
Raid M. Al-Ani

Abstract Introduction: The study aimed to compare the 2 procedures of tonsillectomy (coblation and diode laser) concerning the operative time, the amount of blood loss, postoperative pain, and other complications. Materials and Methods: A comparative study was conducted at many Private Hospitals, Baghdad, Iraq from February 2019- February 2020. Coblation and laser tonsillectomy were performed on the same patient (one for each side) which was blinded to the patients or their caregivers and the surgeon who did the tonsillectomy. Data concerning the age, gender, indications for tonsillectomy, operative time, the amount of the blood loss, post-tonsillectomy pain by VAS scores, and other complications were recorded for each patient. Results: Out of 62 participants, there were 34 (54.8%) females. The majority were from the age group ≤18 years (n=54, 87.1%). The operative time and amount of the intraoperative blood loss were significantly lower in the coblation than a diode laser tonsillectomy. However, the postoperative pain scores in the diode laser were a statistically significant difference less than the coblation group at the periods 3 hours, 8 hours, 24 hours, and 7 days (P-value<0.05). While there was no statistically significant difference between the two groups at 2 weeks postoperative period (P-value=0.392). No primary or secondary postoperative bleeding in all patients. Conclusion: coblation was better than diode laser because of shorter operative time and less intraoperative blood loss. However, the diode laser technique had lesser postoperative pain at the postoperative periods 3 hours, 8 hours, 24 hours, and 7 days than coblation.


Author(s):  
Nithya V. ◽  
Angshuman Dutta ◽  
Sabarigirish K.

<p class="abstract"><strong>Background:</strong> The aim of the present study was to compare intraoperative blood loss, operative duration and postoperative pain between coblation-assisted adenotonsillectomy and cold dissection adenotonsillectomy in children.</p><p class="abstract"><strong>Methods:</strong> A prospective, randomized, single-blind trial of pediatric patients aged 7 to 13 years undergoing adenotonsillectomy was conducted. Patients were randomized to undergo either cold dissection or coblation-assisted adenotonsillectomy. Measured intraoperative parameters included surgical duration and intraoperative blood loss. Measured postoperative parameters included a daily pain rating using the visual analog scale on the postoperative evening, postoperative day 1 and day 7. Intraoperative and postoperative measures were statistically compared between the two groups<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Sixty children were randomized and included in the study. 30 patients underwent cold dissection adenotonsillectomy and 30 coblation-assisted adenotonsillectomy. Mean age was 8.7 years in the coblation group and 9.1 years in the cold dissection group. Intraoperative blood loss was lower for the coblation assisted adenotonsillectomy group versus the cold dissection adenotonsillectomy group which was proved statistically (mean bleeding was 16.67 in coblation group and 58.67 in cold dissection group and p value &lt;0.0001).There was statistically no significant difference in the mean pain scores in the 2 groups in the postoperative evening and on postoperative day 1. The mean pain scores on postoperative day 7 were found to be 3.4 in the coblation group and 2.47 in the cold dissection group with a significant p value of 0.0087. The average duration of surgery in the coblation group was 55.6 minutes as against 34.1 minutes in the cold dissection group. The p- value was found to be less than 0.0001 which makes the difference statistically significant<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> This study found that the intraoperative blood loss was significantly less in Coblation adenotonsillectomy than in cold dissection adenotonsillectomy. The duration of surgery in Coblation assisted adenotonsillectomy is significantly greater than the duration of surgery in cold dissectionadenotonsillectomy. While the postoperative pain scores are similar with coblation and cold dissection adenotonsillectomy in the early postoperative period, it is significantly more with coblation in the late postoperative period<span lang="EN-IN">.</span></p>


2019 ◽  
Vol 13 (2) ◽  
pp. 29-31
Author(s):  
Liza Chowdhury

Introduction: The choice of hysterectomy approach depends on the reason for hysterectomy, the overall health of the patient and surgeon’s experience. The choice of technique dictates hospital stay and healing time. Objective: To compare the efficacy and outcome of Laparoscopic Assisted Vaginal Hysterectomy (LAVH) and traditional Vaginal Hysterectomy (VH). Materials and Method: A total of 100 patients were purposively selected for this prospective comparative study during the period of January 2011 to January 2013 in CMH, Dhaka and Hitech Multicare Hospital. Non-malignant patients undergoing LAVH and VH by the same surgeon were included in this study. Clinical variables such as operative time, operative cost, blood loss, quantity of analgesics used and hospital stay were observed in both cases for comparison. Several other variables were also observed as postoperative complications such as amount of haemoglobin decrease, rise of temperature, urinary tract infection, vault granuloma in both the cases. Results:  There was no significant difference in terms of age, parity, body weight, uterine weight. The mean estimated blood loss in VH (100±32.8 ml) was significantly lower compared to LAVH (126.5±39.8 ml) group. Comparing the relief of post-operative pain, less analgesic was required, rapid patient recovery, and hospital stay time was less in LAVH group than VH group. Conclusion: LAVH is clinically beneficial in terms of less post-operative pain and less quantity of analgesia used, rapid patients’ recovery and shorter hospital stay than VH. It is useful for patients who prefer laparoscopy for cosmetic purpose. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 29-31


2012 ◽  
Vol 18 (2) ◽  
pp. 114-118 ◽  
Author(s):  
MA Matin ◽  
M Alamgir Chowdhury

Introduction: Tonsillectomy is the commonest operation performed in Ear, Nose and Throat Department. Various methods of tonsillectomy have been practiced over the century aimed at  reducing or eliminating intra-operative and postoperative morbidity.Aim: This prospective study is aimed at evaluation of advantages and disadvantages of laser tonsillectomy over blunt dissection tonsillectomy in respect of operative time, intra-operative blood loss, postoperative pain, rate of healing of tonsillar fossa and other postoperative complications.Method: This prospective randomized study was done for 18 months from April 2010 to September 2011.One hundred patients were divided into two groups of equal number. In one group, the tonsillectomy performed by Diode laser and in the other group the tonsillectomy performed by conventional dissection technique.Results: Age ranged from 5 - 34 years with mean age 15.4 in laser group and 4-35 years with mean age 15.98 in dissection group. Operative time and amount of blood loss is significantly reduced in the laser group (10-25 min, mean 12 min in laser group, 15-45 min, and mean 25 min in dissection group). Tonsillectomy by using laser has shown less intra-operative bleeding (5ml-20 ml, mean 10 ml compared with 45-250 ml, mean 70 ml in dissection method). Patients experienced mild to moderate pain in laser group and moderate to severe pain in dissection group in first 24-48 hours. Pain increased in intensity after 5-6 days in laser group. On 8th post operative day thin to thick white coating is observed with smooth tonsillar fossa in laser group whereas granulation tissue is observed in dissection group.Conclusion: In conclusion laser tonsillectomy has some advantages over dissection method.  There is less operative time and intra-operative bleeding and less immediate post operative pain. Disadvantage of laser tonsillectomy is that there is more pain in 5th to 6th post operative period this may be due to thick slough formation. DOI:http://dx.doi.org/10.3329/bjo.v18i2.11983 Bangladesh J Otorhinolaryngol 2012; 18(2): 114-118


Author(s):  
G. Abhinav Kiran ◽  
Y. Prabhakara Rao ◽  
B. Shanthi Priyanka ◽  
Supreety .

<p class="abstract"><strong>Background: </strong>Tonsillectomy is a commonly done surgery by ENT surgeons all over the world. There are many surgical techniques to do this surgery. This study is aimed to compare intraoperative efficiency and postoperative recovery between coblation and bipolar electrocautery tonsillectomy.</p><p class="abstract"><strong>Methods:</strong> This prospective study was carried out on 60 patients that underwent tonsillectomy over 2 years from February 2019 to January 2021 in Mallareddy Institute of Medical Sciences, Suraram, Hyderabad. The patients were equally divided into two groups; coblation tonsillectomy (30 patients) and bipolar electrocautery tonsillectomy (30 patients). Their age ranged between 4-15 years. The operative time and intraoperative blood loss were recorded for each patient and compared. The parents were given a pain diary to record the level of pain each morning for ten days. Also, they were asked to report any complication like bleeding.</p><p class="abstract"><strong>Results:</strong> There was no statistically significant difference in the mean operation time and intra operative blood loss between the coblation group and bipolar electrocautery group There was a statistically significant difference in the daily pain scores between the two groups in which the coblation group was associated with lower mean pain score. 1 episode of secondary hemorrhage was recorded in bipolar electrocautery tonsillectomy.</p><p class="abstract"><strong>Conclusions:</strong> Bipolar electrocautery tonsillectomy offers the same operative speed, similar intraoperative blood loss, more postoperative pain scores when compared with coblation tonsillectomy.</p>


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