Skip to main content

Advertisement

Log in

Harmonic Scalpel Versus Coblation Tonsillectomy A Comparative Study

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Tonsillectomy is an age old procedure in ENT practice. Though traditional dissection method is gold standard, we surgeons are trying different techniques like electrocautery, coblation, harmonic scalpel (HS) mainly to improve surgical convenience, to decrease operative time, post operative pain, intra and post operative bleeding and fast return to normal life. In this particular study we are comparing coblation and HS as surgical tool in tonsillectomy. It is a prospective double-blind randomized controlled trial where information was compared between two groups of coblation and HS tonsillectomy. A total number of 128 patients were compared over operation time, intra-operative blood loss, postoperative pain, time needed to regain the normal diet and activity and postoperative haemorrhage. We found statistically significant differences in operation time (p < 0.001) and intra operative blood loss (p < 0.001). Secondary haemorrhage rate was far better in HS (1.5%) group compared to coblation (7.8%). Whereas postoperative pain, time needed to go back to the normal diet and activity were better in HS group but the difference is not significant. This study revealed a significantly less operative time and intra-operative and post operative blood loss in harmonic scalpel tonsillectomy in comparison with coblation method. These findings addressed HS tonsillectomy as an advanced method.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Lowe D, van der Meulen J, Cromwell D, Lewsey J, Copley L, Browne J et al (2007) Key messages from the national prospective tonsillectomy audit. Laryngoscope. 117(4):717–724

    Article  Google Scholar 

  2. Pinder DK, Wilson H, Hilton MP (2011) Dissection versus diathermy for tonsillectomy. Cochrane Database Syst Rev 3:CD002211

    Google Scholar 

  3. Wiatrak BJ, Willging JP (2002) Harmonic scalpel for tonsillectomy. Laryngoscope 112(8 Pt 2 Suppl 100):14–16

    Article  Google Scholar 

  4. Derkay CS, Maddern BR (2002) Innovative techniques for adenotonsillar surgery in children: introduction and commentary. Laryngoscope 112(8 Pt 2 Suppl 100):2

    Article  Google Scholar 

  5. Plant RL (2002) Radiofrequency treatment of tonsillar hypertrophy. Laryngoscope 112(Pt 2 Suppl 100):20–22

    Article  Google Scholar 

  6. Lee KC, Bent JP, Dolitsky JN, Hinchcliffe AM, Mansfield EL, White AK et al (2004) Surgical advances in tonsillectomy: report of a roundtable discussion. Ear Nose Throat 83(8 Suppl 3):4–13

    Article  Google Scholar 

  7. Bessa SS, Al-Fayoumi TA, Katri KM, Awad AT (2008) Clipless laparoscopic cholecystectomy by ultrasonic dissection. J Laparoendosc Adv Surg Tech A 18:593–598

    Article  Google Scholar 

  8. Seehofer D, Mogl M, Boas-Knoop S et al (2012) Safety and efficacy of new integrated bipolar and ultrasonic scissors compared to conventional laparoscopic 5-mm sealing and cutting instruments. Surg Endosc 26(9):2541–2549. https://doi.org/10.1007/s00464-012-2229-0

    Article  PubMed  PubMed Central  Google Scholar 

  9. Lenihan J, Kovanda C, Commerano C (2004) Comparison of laparoscopic-assisted vaginal hysterectomy with traditional hysterectomy for cost-effectiveness to employers. Am J Obstet Gynecol 190:1714–1722. https://doi.org/10.1016/j.ajog.2004.02.059

    Article  PubMed  Google Scholar 

  10. Belloso A, Chidambaram A, Morar P, Timms MS (2003) Coblation tonsillectomy versus dissection tonsillectomy: postoperative hemorrhage. Laryngoscope 113(11):2010–2013

    Article  Google Scholar 

  11. Temple RH, Timms MS (2001) Paediatric coblation tonsillectomy. Int J Pediatr Otorhinolaryngol 61(3):195–198

    Article  CAS  Google Scholar 

  12. Polites N, Joniau S, Wabnitz D, Fassina R, Smythe C, Varley P et al (2006) Postoperative pain following coblation tonsillectomy: randomized clinical trial. ANZ J Surg 76(4):226–229

    Article  Google Scholar 

  13. Timms MS, Temple RH (2002) Coblation tonsillectomy: a double blind randomized controlled study. J Laryngol Otol 116(6):450–452

    Article  CAS  Google Scholar 

  14. Burton MJ, Doree C (2007) Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev 3:CD004619

    Google Scholar 

  15. Noon AP, Hargreaves S (2003) Increased postoperative haemorrhage seen in adult coblation tonsillectomy. J Laryngol Otol 117(9):704–706

    Article  CAS  Google Scholar 

  16. Back L, Paloheimo M, Ylikoski J (2001) Traditional tonsillectomy compared with bipolar radiofrequency thermal ablation tonsillectomy in adults: a pilot study. Arch Otolaryngol Head Neck Surg 127(9):1106–1112

    Article  CAS  Google Scholar 

  17. Shah UK, Galinkin J, Chiavacci R, Briggs M (2002) Tonsillectomy by means of plasma-mediated ablation: prospective, randomized, blinded comparison with monopolar electrosurgery. Arch Otolaryngol Head Neck Surg 128(6):672–676

    Article  Google Scholar 

  18. Litta P, Fantinato S, Calonaci F et al (2010) A randomized controlled study comparing harmonic versus electrosurgery in laparoscopic myomectomy. Fertil Steril 94:1882–1886. https://doi.org/10.1016/j.fertnstert.2009.08.049

    Article  PubMed  Google Scholar 

  19. Ivanov D, Babovic S, Selesi D, Ivanov M, Cvijanovic R (2007) Harmonic scalpel hemorrhoidectomy: a painless procedure? Med Pregl 60:421–426

    Article  Google Scholar 

  20. Shinhar S, Scotch BM, Benlenky W, Madgy D, Haupert M (2004) Harmonic scalpel tonsillectomy versus hot electrocautery and cold dissection: an objective comparism. Ear Nose Throat J 83:712–715

    Article  Google Scholar 

  21. Kurzynski M, Szaleniec J (2008) Skladzien J [Harmonic scalpel tonsillectomypersonal experience and review of literature]. Otolaryngol Pol 62:561–566

    Article  Google Scholar 

  22. Walker RA, Syed ZA (2001) Harmonic scalpel tonsillectomy versus electrocautery tonsillectomy: a comparative pilot study. Otolaryngol Head Neck Surg 125:449–455

    Article  CAS  Google Scholar 

  23. Sood S, Corbridge R, Powels J, Bates G, Newbegin CJ (2001) Effectiveness of the ultrasonic harmonic scalpel for tonsillectomy. Ear Nose Throat J 80:514–516

    Article  CAS  Google Scholar 

  24. Akural EI, Koivunen PT, Teppo H, Alahuhta SM, Loponen HJ (2001) Posttonsillectomy pain: a prospective, randomized and double blinded study to compare an ultrasonically activated scalpel technique with the blunt dissection technique. Anaethesia 56:1045–1050

    Article  CAS  Google Scholar 

  25. Schrey A, Pulkkinen J, Fremling C, Kinnunen I (2004) Ultrasonically activated scalpel compared with electrocautery in tonsillectomy. ORL J Otorhinolaryngol Relat Spec 66:136–140

    Article  Google Scholar 

  26. Gilbey P, Gadban H, Letichevsky V, Talmon Y (2008) Harmonic scalpel tonsillectomy using the curved shears instrument versus cold dissection tonsillectomy: a retrospective study. Ann Otol Rhinol Laryngol 117:46–50

    Article  Google Scholar 

  27. Kamal SA, Basu S, Kapoor L, Kulandaivelu G, Talpalikar S, Papasthatis D (2006) Harmonic scalpel tonsillectomy: a prospective study. Eur Arch Otorhinolaryngol 263:449–454

    Article  CAS  Google Scholar 

  28. Collison PJ, Weiner R (2004) Harmonic scalpel versus conventional tonsillectomy: a double-blind clinical trial. Ear Nose Throat J 83:707–710

    Article  Google Scholar 

  29. Powell NB, Riley RW, Troell RJ, Blumen MB, Guilleminault C (1997) Radiofrequency volumetric reduction of the tongue. A porcine pilot study for the treatment of obstructive sleep apnea syndrome. Chest 111(5):1348–1355

    Article  CAS  Google Scholar 

  30. Stoker KE, Don DM, Kang DR, Haupert MS, Magit A, Madgy DN (2004) Pediatric total tonsillectomy using coblation compared to conventional electrosurgery: a prospective, controlled single-blind study. Otolaryngol Head Neck Surg 130(6):666–675

    Article  Google Scholar 

  31. Parsons SP, Cordes SR, Comer B (2006) Comparison of posttonsillectomy pain using the ultrasonic scalpel, coblator, and electrocautery. Otolaryngol Head Neck Surg 134(1):106–113

    Article  Google Scholar 

  32. Philpott CM, Wild DC, Mehta D, Daniel M, Banerjee AR (2005) A double-blinded randomized controlled trial of coblation versus conventional dissection tonsillectomy on postoperative symptoms. Clin Otolaryngol 30(2):143–148

    Article  CAS  Google Scholar 

  33. Arya A, Donne AJ, Nigam A (2003) Double-blind randomized controlled study of coblation tonsillotomy versus coblation tonsillectomy on postoperative pain. Clin Otolaryngol Allied Sci 28(6):503–506

    Article  CAS  Google Scholar 

  34. Anonymous (2002) Interventional procedure overview of coblation tonsillectomy. Anonymous, London

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anindita Sengupta.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Basu, S., Sengupta, A., Dubey, A.B. et al. Harmonic Scalpel Versus Coblation Tonsillectomy A Comparative Study. Indian J Otolaryngol Head Neck Surg 71, 498–503 (2019). https://doi.org/10.1007/s12070-019-01679-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-019-01679-x

Keywords

Navigation