scholarly journals Diode laser versus blunt dissection tonsillectomy

2012 ◽  
Vol 18 (2) ◽  
pp. 114-118 ◽  
Author(s):  
MA Matin ◽  
M Alamgir Chowdhury
Keyword(s):  
Blood Loss ◽  
Diode Laser ◽  
Operative Time ◽  
Randomized Study ◽  
Blunt Dissection ◽  
Tonsillar Fossa ◽  
Advantages And Disadvantages ◽  
Post Operative Pain ◽  
Laser Group ◽  
Dissection Method

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

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
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Pain Intensity ◽  
Postoperative Blood Loss ◽  
Intraoperative Blood Loss ◽  
Advantages And Disadvantages ◽  
Post Operative Pain ◽  
Significant Difference ◽  
The Mean ◽  
Dissection Method

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.

scholarly journals Coblation versus Diode Laser Tonsillectomy in Children: A Randomized Controlled Trial

2020 ◽  
Vol 23 (2) ◽  
pp. 140-145
Author(s):  
MA Matin ◽  
MA Sabur ◽  
MAK Azad ◽  
MN Islam
Keyword(s):  
Blood Loss ◽  
Diode Laser ◽  
Operative Time ◽  
Controlled Trial ◽  
Sleep Apnoea ◽  
Normal Diet ◽  
Recurrent Tonsillitis ◽  
Soft Diet ◽  
Laser Group ◽  
Early Returns

Objective: This study aimed to compare the efficacy of diode laser and coblation tonsillectomy in paediatric patients in relation to operative time, amount of blood loss, post operative pain, healing of tonsillar fossa and returns to normal diet. Methods: A total of 200 patients ,100 for coblaton and 100 for diode laser, aged 3-12 years with recurrent tonsillitis with or without snoring and sleep apnoea were recruited. Participants were prospectively randomised to diode laser and coblation tonsillectomy. Operative time and blood loss were recorded. Pain was recorded by VAS or assessed by using analgesic. Results: The operative time were recorded 07-15 minutes,mean 10 minutes in coblation group and 12-20 minutes ,mean 14 minutes in laser group., Blood loss was recorded 0-15 ml mean 8 ml in coblation group and 10-25 ml mean 13.5 ml in diode laser group . However, at post-operative day seven, the diode laser tonsillectomy group had significantly higher pain scores compared with coblationtonsillectomy groups.Coblation group started normal soft diet on day 5 whereas diode laser started on day 8 Conclusion: Coblation tonsillectomy is associated with less operative time and blood loss, early returns to normal diet and less pain score in comparison to Diode laser tonsillectomy Bangladesh J Otorhinolaryngol; October 2017; 23(2): 140-145

Pilot comparison between potassium titanyl phosphate laser and bipolar radiofrequency in paediatric tonsillectomy

2008 ◽  
Vol 122 (4) ◽  
pp. 369-373 ◽  
Author(s):  
H M Hegazy ◽  
O A Albirmawy ◽  
A H Kaka ◽  
A S Behiry
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Potassium Titanyl Phosphate ◽  
Complication Rates ◽  
Operative Blood Loss ◽  
Bipolar Radiofrequency ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Laser Group ◽  
Potassium Titanyl Phosphate Laser

AbstractObjectives:To compare the advantages and disadvantages of potassium titanyl phosphate laser with those of bipolar radiofrequency techniques, in paediatric tonsillectomy.Study design:Prospective, randomised, clinical study.Patients and methods:From July 2004 to April 2006, 80 patients aged between 10 and 15 years, with tonsillectomy planned for chronic tonsillitis, were included in the study. Children were prospectively randomised into two equal groups: potassium titanyl phosphate laser tonsillectomy and bipolar radiofrequency tonsillectomy. Operative time and intra-operative blood loss were recorded. Patients were scheduled for follow up during the first, second and fourth post-operative weeks. They were asked to record their pain and discomfort on a standardised visual analogue scale, from zero (no pain) to 10 (severe pain). Post-operative complications were also recorded and managed.Results:The potassium titanyl phosphate laser group showed a slightly longer operative time (mean 12 minutes) than the bipolar radiofrequency group (mean 10 minutes). Intra-operative blood loss was significantly less in the potassium titanyl phosphate laser group (mean 21 cm3) than in the bipolar radiofrequency group (mean 30 cm3). In the first week, post-operative pain scores were less in the potassium titanyl phosphate laser group than in the bipolar radiofrequency group (means 7.5 and 8.5, respectively). However, in the second week pain scores increased more in the potassium titanyl phosphate laser group than in the bipolar radiofrequency group (means 8.5 and 6, respectively). In the fourth week, both groups showed equal and nearly normal pain scores. No case of reactionary post-tonsillectomy haemorrhage was recorded in either group. Only one case of secondary post-tonsillectomy haemorrhage was recorded, in the potassium titanyl phosphate laser group (2.5 per cent), managed conservatively.Conclusion:Both the potassium titanyl phosphate and the bipolar radiofrequency techniques were safe and easy to use for tonsillectomy, with reduced operative time, blood loss and complication rates and better post-operative general patient condition. Potassium titanyl phosphate laser resulted in reduced operative bleeding and immediate post-operative pain, compared with the bipolar radiofrequency technique. However, potassium titanyl phosphate laser required slightly more operative time and caused more late post-operative pain than the bipolar radiofrequency technique. The low rate of recorded complications showed that both techniques cause little damage to the tonsillar bed during dissection, thus minimising complications.

scholarly journals Coblation Tonsillectomy Versus Blunt Dissectomy Tonsillectomy in Children

2013 ◽  
Vol 4 (1) ◽  
pp. 25-29 ◽  
Author(s):  
M A Matin ◽  
M Alamgir Chowdhury ◽  
Md Enamul Haque ◽  
Md Nurul Islam ◽  
Tahsina Shamim ◽  
...  
Keyword(s):  
Blood Loss ◽  
Granulation Tissue ◽  
Operative Time ◽  
Randomized Study ◽  
Normal Diet ◽  
The Other ◽  
Female Ratio ◽  
Tonsillar Fossa ◽  
Early Return ◽  
Maximum Pain

Tonsillectomy is one of the most common surgical procedure performed world wide by the ENT Surgeons.Various methods of tonsillectomy have been practiced over the century aimed at reducing or eliminating intraoperative and postoperative morbidity. Coblation tonsillectomy is a recently introduced surgical technique. Tonsillectomy over blunt dissection tonsillectomy in respect of operative time, intraoperative blood loss, postoperative pain, rate of healing of tonsillar fossa and  other postoperative complications. This prospective randomized study was done at Maleka Nursing  Home, Bogra and Bangladesh ENT Hospital, Dhaka for 36 months from 1st January 2008 to 31December 2010. 200 children were divided into two groups of equal number. In one group, the tonsillectomy performed by Coblation method and in the other group the tonsillectomy Age ranged from 3-12 years with mean age 5.6 in coblation group and 4-14 years with mean age 7.2 in dissection group. Number of male patients were slightly more than female with male female ratio was 3:2 in coblation group and 3.7:2 in dissection group. Operative time and amount of blood loss is significantly reduced in the coblation group (10-25 min, mean 12 min in coblation group, 18-35 min, mean 25 min in dissection group. Tonsillectomy by using coblation have shown less intraoperative bleeding (5ml-100 ml, mean 15 ml compared with 50-230 ml, mean 65 ml in dissection method).During post operative follow-up on day 8, children of coblation group experienced mild to moderate  pain with maximum pain on day 2 and no pain on day 8. On the other hand dissection group  experienced moderate to severe pain with maximum pain on day 4 and little or no pain on day 8.Children of coblation group returned to normal diet on day 3 and children of dissection group on  day 8.On 8th post operative day, coblation group showed smooth healing without any granulation tissue in tonsillar fossa whereas granulation tissue is observed in dissection group. No major complications were noted in any group except one secondary haemorrhage in dissection group. Coblation tonsillectectomy offers less operative time, minimum blood loss, less post operative pain,early return to normal diet and rapid healing of tonsillar fossa. DOI: http://dx.doi.org/10.3329/akmmcj.v4i1.13681 AKMMC J 2013: 4(1): 25-29  

A randomised controlled trial of coblation, diode laser and cold dissection in paediatric tonsillectomy

2015 ◽  
Vol 129 (11) ◽  
pp. 1058-1063 ◽  
Author(s):  
M R Elbadawey ◽  
H M Hegazy ◽  
A E Eltahan ◽  
J Powell
Keyword(s):  
Blood Loss ◽  
Diode Laser ◽  
Operative Time ◽  
Controlled Trial ◽  
Pain Scale ◽  
Recurrent Tonsillitis ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Randomised Controlled ◽  
Cold Dissection

AbstractObjective:This study aimed to compare the efficacy of diode laser, coblation and cold dissection tonsillectomy in paediatric patients.Methods:A total of 120 patients aged 10–15 years with recurrent tonsillitis were recruited. Participants were prospectively randomised to diode laser, coblation or cold dissection tonsillectomy. Operative time and blood loss were recorded. Pain was recorded on a Wong–Baker FACES®pain scale.Results:The operative time (10 ± 0.99 minutes), blood loss (20 ± 0.85 ml) and pain were significantly lower with coblation tonsillectomy than with cold dissection tonsillectomy (20 ± 1.0 minutes and 30 ± 1.0 ml;p= 0.0001) and diode laser tonsillectomy (15 ± 0.83 minutes and 25 ± 0.83 ml;p= 0.0001). Diode laser tonsillectomy had a shorter operative time (p= 0.0001) and less blood loss (p= 0.001) compared with cold dissection tonsillectomy. However, at post-operative day seven, the diode laser tonsillectomy group had significantly higher pain scores compared with the cold dissection (p= 0.042) and coblation (p= 0.04) tonsillectomy groups.Conclusion:Both coblation and diode laser tonsillectomy are associated with significantly reduced blood loss and shorter operative times compared with cold dissection tonsillectomy. However, we advocate coblation tonsillectomy because of the lower post-operative pain scores compared with diode laser and cold dissection tonsillectomy.

scholarly journals Holmium laser enucleation of the prostate with Virtual Basket mode: faster and better control on bleeding

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giorgio Bozzini ◽  
Matteo Maltagliati ◽  
Umberto Besana ◽  
Lorenzo Berti ◽  
Albert Calori ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
Randomized Study ◽  
Urine Volume ◽  
Holmium Laser ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation ◽  
Irrigation Volume

Abstract Background To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate using the Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH). Methods This prospective randomized study enrolled consecutive patients with BPH, who were assigned to undergo either HoLEP (n = 100), or VB-HoLEP (n = 100). All patients were evaluated preoperatively and postoperatively, with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We also evaluated the patients at 3 and 6 months after surgery and assessed maximum flow rate (Qmax), postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS) and the Quality of Life score (QOLS). Results No significant differences in preoperative parameters between patients in each study arm were found. Compared to HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs. 1.12 g/dl, P = 0.03) and reduced operative time (57.33 ± 29.71 vs. 42.99 ± 18.51 min, P = 0.04). HoLEP and VB-HoLEP detrmined similar catheterization time (2.2 vs. 1.9 days, P = 0.45), irrigation volume (33.3 vs. 31.7 l, P = 0.69), and hospital stay (2.8 vs. 2.7 days, P = 0.21). During the 6-month follow-up no significant differences in IPSS, Qmax, PVR, and QOLS were demonstrated. Conclusions HoLEP and VB-HoLEP are both efficient and safe procedures for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and operative time. However, procedures did not differ significantly in catheterization time, hospital stay, and irrigation volume. No significant differences were demonstrated in QOLS, IPSS, Qmax and PVR throughout the 6-month follow-up. Trial Registration: Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.

scholarly journals The Health Impact of Surgical Techniques and Assistive Methods Used in Cesarean Deliveries: A Systemic Review

2020 ◽  
Vol 17 (18) ◽  
pp. 6894
Author(s):  
Li-Hsuan Wang ◽  
Kok-Min Seow ◽  
Li-Ru Chen ◽  
Kuo-Hu Chen
Keyword(s):  
Blood Loss ◽  
Cesarean Delivery ◽  
Operative Time ◽  
Surgical Techniques ◽  
Systemic Review ◽  
Fetal Head ◽  
Advantages And Disadvantages ◽  
Cesarean Deliveries ◽  
Fundal Pressure

Cesarean delivery is one of the most frequently performed surgeries in women throughout the world. However, the most optimal technique to minimize maternal and fetal morbidities is still being debated due to various clinical situations and surgeons’ preferences. The contentious topics are the use of vacuum devices other than traditional fundal pressure to assist in the delivery of the fetal head and the techniques of uterine repair used during cesarean deliveries. There are two well-described techniques for suturing the uterus: The uterus can be repaired either temporarily exteriorized (out of abdominal cavity) or in situ (within the peritoneal cavity). Numerous studies have attempted to compare these two techniques in different aspects, including operative time, blood loss, and maternal and fetal outcomes. This review provides an overview of the assistive method of vacuum devices compared with fundal pressure, and the two surgical techniques for uterine repair following cesarean delivery. This descriptive literature review was performed to address important issues for clinical practitioners. It aims to compare the advantages and disadvantages of the assistive methods and surgical techniques used in cesarean deliveries. All of the articles were retrieved from the databases Medline and PubMed using the search terms cesarean delivery, vacuum, and exteriorization. The searching results revealed that after exclusion, there were 9 and 13 eligible articles for vacuum assisted cesarean delivery and uterine exteriorization, respectively. Although several studies have concluded vacuum assistance for fetal extraction as a simple, effective, and beneficial method during fetal head delivery during cesarean delivery, further research is still required to clarify the safety of vacuum assistance. In general, compared to the use of in situ uterine repairs during cesarean delivery, uterine exteriorization for repairs may have benefits of less blood loss and shorter operative time. However, it may also carry a higher risk of intraoperative complications such as nausea and vomiting, uterine atony, and a longer time to the return of bowel function. Clinicians should consider these factors during shared decision-making with their pregnant patients to determine the most suitable techniques for cesarean deliveries.

Comparative study of management of inferior turbinate hypertrophy using turbinoplasty assisted by microdebrider or 980 nm diode laser

2012 ◽  
Vol 126 (12) ◽  
pp. 1231-1237 ◽  
Author(s):  
A N Kassab ◽  
M Rifaat ◽  
Y Madian
Keyword(s):  
Diode Laser ◽  
Operative Time ◽  
Inferior Turbinate ◽  
The Other ◽  
Success Rates ◽  
Non Invasive ◽  
Turbinate Hypertrophy ◽  
Operative Complications ◽  
Laser Group ◽  
Inferior Turbinate Hypertrophy

AbstractObjective:This study aimed to compare the outcomes of turbinoplasty assisted by microdebrider and by diode laser (980 nm wavelength).Methods:Forty patients suffering from bilateral nasal obstruction were randomly divided into two equal groups. One group was managed with microdebrider-assisted turbinoplasty and the other with diode laser assisted turbinoplasty. The patients were followed up for six months post-operatively.Results:After six months, total success rates were 90 per cent for the microdebrider group and 85 per cent for the diode laser group. There were no significant differences between the two groups regarding success rate, post-operative complications or operative time.Conclusion:These two techniques are equally safe, reliable, successful and non-invasive.

scholarly journals A study of single sight two port laparoscopic appendectomy for its feasibility, advantages and disadvantages

2020 ◽  
Vol 7 (8) ◽  
pp. 2709
Author(s):  
Dinesh Prasad ◽  
Rajesh Chandanani ◽  
Kesha Shah
Keyword(s):  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Advantages And Disadvantages ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Severe Reduction ◽  
Hospital Stays ◽  
Reduced Port ◽  
Invasive Techniques ◽  
Surgeon Satisfaction

Minimally invasive techniques revolutionized surgery with severe reduction of access trauma, prompt mobilization, lessened hospital stays and better cosmesis.1 Laparoscopic appendectomy can be further categorized into three port and reduced port appendectomy. All the selected cases have been put in a tabulated form on the basis of their age, clinical features and signs, ultrasonography findings, intra op complications, duration of surgery, duration of post op pain, early post op complications, cosmetic outcome and trochar size. 20 patients fulfilling inclusion and exclusion criteria, who were admitted in our hospital (SMIMER Surat) from 1st December, 2019 to 1st April 2020 and were included in the study and underwent single sight two port laparoscopic appendectomy (SSTPLA) after their consent. We have covered the entire procedure of single sight two port appendectomy, its technique, feasibility, advantages, and disadvantages. From our study, we conclude that this new technique of SSTPLA is technically safe and feasible. Our experience of this innovative surgical technique is suggestive of the fact that SSTPLA has better patient satisfaction with respect to cosmesis, decreased post-operative pain, decreased hospital stay, decreased operative time, fewer intra operative and post-operative complications and surgeon satisfaction with respect to ergonomics and decreased chances of collision of laparoscope with only single working instrument.

scholarly journals Advantages of ultrasonic tonsillectomy by harmonic scalpel

1970 ◽  
Vol 16 (2) ◽  
pp. 91-95
Author(s):  
M Alamgir Chowdhury ◽  
Naseem Yasmeen ◽  
SM Gplam Rabbani ◽  
Mousumi Malakar ◽  
Farzana Hoque ◽  
...  
Keyword(s):  
Nursing Home ◽  
Prospective Study ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Oral Feeding ◽  
Age Group ◽  
Advantages And Disadvantages ◽  
Secondary Hemorrhage ◽  
Post Operative Pain ◽  
A Prospective Study

Objective: To find out the advantages and disadvantages of ultrasonic tonsillectomy by harmonic scalpel.Design and setting: A prospective study was conducted over a period of five years; from 01.07.2005 to 30.06.2010 in Comfort Nursing Home, 167B, Green Road, Dhaka, Bangladesh.Results: Hospital admitted 540 cases of ultrasonic harmonic scalpel tonsillectomy were included and analyzed. 360 cases were male; whereas 180 cases were female in this study. 0-10 years (168 cases) were the commonest age group of study people. Complications were rare, only two cases 0.37% of secondary hemorrhage had happened and no cases of reactionary hemorrhage was reported.Conclusion: The advantages are almost no bleeding, precise dissection of tonsils, less post operative pain, reduce postoperative discomfort, earlier return to normal activities, oral feeding immediately after operation and less operative time. Key words: Ultrasonic tonsillectomy; Harmonic scalpel. DOI: 10.3329/bjo.v16i2.6843Bangladesh J Otorhinolaryngol 2010; 16(2): 91-95

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