Skip to main content

Ligation Versus Bipolar Diathermy for Hemostasis in Tonsillectomy: A Comparative Study

Indian Journal of Otolaryngology and Head & Neck Surgery volume 63, pages 15–19 (2011)Cite this article

Abstract

Tonsillectomy despite being less performed nowadays still is a very common surgery performed by ENT surgeons. The use of various modalities like bipolar diathermy, laser, cryosurgery, radiofrequency and ionic coblation for hemostasis in tonsillectomy remains controversial so far. A thorough scan of literature comparing the ligation with diathermy has been presented. In this prospective study, we analysed 50 patients undergoing tonsillectomy by dissection method. Right sided tonsillectomies act as study group (bipolar diathermy used) and left sided tonsillectomies as the control group (ligation for hemostasis used). The aim of our study is to compare the amount of blood loss, number of ligatures applied, average time taken and incidence of postoperative haemorrhage following the use of ligation and bipolar diathermy. The study found that diathermy hemostatic technique is associated with a quicker procedure, less intraoperative blood loss, comparable postoperative pain.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

Reference

  1. Ozdemir I, Ercan MT, Kaya S (1985) Measurement of tonsillar blood flow in normal and pathological conditions by the use of the 133 Xe clearance technique. Arch Otorhinolaryngol 242:53–56

    PubMed  Article  CAS  Google Scholar 

  2. MacBeth RG (1950) The tonsil problem. J Laryngol Otol 64:591

    Google Scholar 

  3. Hibbert J, Cowan DL (1997) Scott brown’s otolaryngology. In: acute and chronic infections of the pharynx and tonsils. 6th edn. Butter Worth Heinemann International Edition, Great Britain, pp 17–22

  4. Sharp JF, Rogres MJC, Riad M, Kerr AIG (1991) Combined study to asses the role of calcium alginate swabs and ligation of the inferior tonsillar pole in the control of intraoperative blood loss during tonsillectomy. J Laryngol Otol 105:191–194

    PubMed  Article  CAS  Google Scholar 

  5. Rasgon BM, Crug RM, Hilsinger RL (1991) Infiltration of epinephrine in tonsillectomy. A randomized prospective, double blind study. Laryngoscope 101:114–118

    PubMed  Article  CAS  Google Scholar 

  6. Hibbert J, Cowan DL (1997) Scott brown’s otolaryngology. In: acute and chronic infections of the pharynx and tonsils, vol 5, 6th edn. Butter Worth Heinemann International Edition, Great Britain, pp 20–21

  7. Malik MK, Bhatia BRR, Kumar A (1982) Control of haemorrhage in tonsillectomy. J Ind Med Assoc 79:115–117

    CAS  Google Scholar 

  8. Hill CL (1966) Preliminary report on cryosurgery in otolaryngology. Laryngoscope 76:109

    Article  Google Scholar 

  9. Verstraeta M, Vermylen J, Tyeberghein J (1968) Double blind evaluation of hemostatic effect of adrenochrome monosemicarbazone, conjugated estrogens and epsilon aminocaproic acid after adenotonsillectomy. Acta Haematol Basel 40:154–161

    Article  Google Scholar 

  10. Langford Richard M, Mythen Monty C (2000) Critical care; Fluid, electrolyte and acid-base balance; blood transfusion. Bailey and Love’s short practice of surgery 23:40–63

    Google Scholar 

  11. Carmody D, Vamadevan T, Cooper SM (1982) Post tonsillectomy. J Laryngol Otol 96:635–638

    PubMed  Article  CAS  Google Scholar 

  12. Watson MG, Dawer PJO, Samuel PR (1993) A study of hemostasis following tonsillectomy comparing ligatures with diathermy. J Laryngol Otol 107:711–715

    PubMed  Article  CAS  Google Scholar 

  13. Choy ATK (1992) Bipolar diathermy or ligation for hemostasis in tonsillectomy a prospective study on postoperative pain. J Laryngol Otol 106:21–22

    PubMed  CAS  Google Scholar 

  14. Tay HL (1995) Post-operative morbidity in electrodissection tonsillectomy. J Laryngol Otol 109:209–211

    PubMed  CAS  Google Scholar 

  15. Lowe DA (2004) Use of bipolar diathermy in tonsillectomy is a powerful risk factor for haemorrhage. Otolaryngol Head Neck surg 131:127–128

    Article  Google Scholar 

  16. Maini S, Waine E, Evans K (2008) Increased post-tonsillectomy secondary haemorrhage with disposable instruments: an audit cycle. Clin Otolaryngol 2002; 27:175–178 (Quoted by Scott Brown’s Otorhinolarygology, Head and Neck Surgery, 7th edn. 1:1239)

    Google Scholar 

  17. Hemant K, Subrahmanyam, George Zacharias (2008) Electrodissection tonsillectomy using bipolar cautery forceps versus dissection and snare method-comparative study. Asian J Ear, Nose and Throat: 26–29

Download references

Author information

Affiliations

  1. Department of ENT, Goverment Medical College, 39-B, Circular Road, Amritsar, 143001, Punjab, India

    Karan Sharma

  2. Junior Resident ENT, Goverment Medical College, Amritsar, 143001, Punjab, India

    Devinder Kumar

Authors
  1. Karan Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Devinder Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karan Sharma.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Sharma, K., Kumar, D. Ligation Versus Bipolar Diathermy for Hemostasis in Tonsillectomy: A Comparative Study. Indian J Otolaryngol Head Neck Surg 63, 15–19 (2011). https://doi.org/10.1007/s12070-010-0094-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-010-0094-5

Keywords

  • Tonsillectomy
  • Hemostasis
  • Bipolar diathermy
  • Ligation
  • Intraoperative blood loss