Thunderbeat versus bipolar diathermy in surgical outcome of tonsillectomy

Bikash Lal Shrestha; Samir Karmacharya; Pradeep Rajbhandari

doi:10.18203/issn.2454-2156.IntJSciRep20180395

Authors

Bikash Lal Shrestha Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal
Samir Karmacharya Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal
Pradeep Rajbhandari Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal

DOI:

https://doi.org/10.18203/issn.2454-2156.IntJSciRep20180395

Keywords:

Bipolar diathermy, Cold dissection, Harmonic scalpel, Thunderbeat, Tonsillectomy

Abstract

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for the different indications. There are different studies in literature comparing bipolar diathermy with either harmonic scalpel or cold dissection but the thunderbeat is still not used in tonsillectomy. The thunderbeat device which is the integration of ultrasonic and advanced bipolar energies used exclusively in laparoscopic surgery but still not used in tonsillectomy. So, the main aim of this study is to compare the thunderbeat device with bipolar diathermy in surgical outcome of tonsillectomy.

Methods: This was the prospective study performed in total 25 patients. The patients included in the study underwent tonsillectomy on one side using thunderbeat device and on the other side using bipolar diathermy. The intra-operative blood loss, operative time and post-operative pain were taken for analysis in both the surgical procedures. All the data were analyzed with the statistical package for the social sciences (SPSS) software version 20.

Results: Among the twenty five patients, the age groups range from 19-36 years with mean age 25.36±5.62 years. Out of 25 patients, 7 were male and 18 were female. The comparison of operation time and intra-operative blood loss between thunderbeat and bipolar diathermy showed statistically significant differences. The comparison of pain score showed statistically significant result with better pain results in bipolar diathermy.

Conclusions: The thunderbeat uses in tonsillectomies is less time consuming and decrease intra-operative blood loss. But, the post-operative pain is more as compared to bipolar diathermy. Though, it is safe and effective in performing tonsillectomy but its cost is the main drawback for its regular use.

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Author Biographies

Bikash Lal Shrestha, Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal

Department of otorhinolaryngology and head and neck surgery,

Associate Professor

Samir Karmacharya, Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal

Department of otorhinolaryngology, Dhulikhel Hospital

Second year resident

Pradeep Rajbhandari, Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal

Department of otorhinolaryngology, Dhulikhel Hospital

Final year resident

References

Scott A. Hot techniques for tonsillectomy. Issues Emerg health Technol. 2006;93:1-6.

Tariq M, Khan AM. Assessment of secondary haemorrhage following tonsillectomy. Ann King Edward Med Coll. 2004;10:391-3.

Ishlah LW, Fahmi AM, Srinovianti N. Laser versus dissection technique of tonsillectomy. Med J Malaysia 2005;60:76-80.

Parsons SP, Cordes SR, Comer B. Comparison of posttonsillectomy pain using the ultrasonic scalpel, coblator, and electrocautery. Otolaryngol Head Neck Surg. 2006;134:106-13.

Ahmad MM, Bassiouny A. Harmonic Scalpel Tonsillectomy Versus Bipolar Electrocautery and Cold Dissection. Med J Cairo Univ. 2009;77(3):141-5.

Kurznski M, Szaleniec J, Skiadien J. Harmonic scalpel tonsillectomy-personal experience and review of literature. Otolaryngol. Pol. 2008;62(5):561-6.

Roth JA, Pincock T, Sacks R, Forer M, Boustred N, Johnston W, et al. Harmonic scalpel tonsillectomy versus monopolar diathermy tonsillectomy: a prospective study. Ear Nose Throat J. 2008;87(6):346-9.

Obonna GC, Mishra RK. Differences between thunderbeat, ligasure and harmonic scalpel energy system in minimal invasive surgery. World J Laparoscopic Surg. 2014;7(1):41-4.

McCarus SD. Physiological mechanism of the ultrasonically activated scalpel. J Am Assoc Gynaecol Laparosc. 1996;3:601-8.

Sheahan P, Miller I, Colreavy M, Sheahan JN, McShane D, Curran A. The ultrasonically activated scalpel versus bipolar diathermy for tonsillectomy: a prospective randomized trial. Clin Otolaryngol Allied Sci. 2004;29(5):530-4.

Walker RA, Syed ZA. Harmonic scalpel tonsillectomy versus electrocautery tonsillectomy: a comparative pilot study. Otolaryngol Head Neck Surg. 2001;125:449–55.

Ochi K, Ohashi T, Sugiura N. Tonsillectomy using an ultrasonically activated scalpel. Laryngoscope. 2000;110:1237–8.

Wiatrak BJ, Willging JP. Harmonic scalpel for tonsillectomy. Laryngoscope. 2002;112:14–6.

Pizzuto MP, Brodsky L, Duffy L. A comparison of microbipolar cautery dissection to hot knife and cold knife cautery tonsillectomy. Int J Pediatr Otorhinolaryngol. 2000;52:239-46.

Laycock WS, Trus TL, Hunter JG. New technology for the division of short gastric vessels during laparoscopic Nissen funduplication. A prospective randomized trial. Surg Endosc. 1996;10:71–3.

Akural EI, Koivunen PT, Teppo H. Post tonsillectomy pain: a prospective, randomised and double blinded study to compare an ultrasonically activated scalpel technique with the blunt dissection technique. Anaesthesia 2001;65:1045–50.