Hemorroidectomía con Ligasure vs diatermia convencional: análisis retrospectivo monocéntrico / [Ligasure vs conventional diathermy in excisional haemorrhoidectomy: a retrospective study of a single center].

INTRODUCTION: Hemorrhoids are a prolapse of vasculopathic structures that cushion the anal canal and haemorrhoidectomy is the most effective treatment for grades III and IV In this retrospective study we compare the outcome after haemorrhoidectomy with Ligasure or with conventional diathermy. METHODS: From June 2005 to March 2009 we analyzed 75 patients affected by hemorrhoids (grades III and IV) who underwent haemorrhoidectomy in the University Hospital Arnau de Vilanova in Lleida. We evaluated the technique, the age and the sex, and compared the post-operative hospital stay, the post-operative pain and the complications with each of the techniques. RESULTS: We used Ligasure technique in 49 patients (65

) and conventional diathermy technique in 26 (35

). The mean age was 50.3 years. There was no significant difference in both postoperative length ofstay, with an average of2.13 days (P = 0.60), and postoperative pain in the first 15 days (P = 0.275). On the contrary, we found a significant difference in the rate of postoperative complications (P = 0.032) and in the post-surgical pain at one month (P = 0.03). CONCLUSIONS: In our experience the Ligasure haemorrhoidectomy has shown to have fewer complications and post-operative pain when compared with conventional diathermy haemorrhoidectomy.

Reducing post operative bleeding after tonsillectomies in children by modifying the monopolar diathermy technique: a study of 1500 patients

To evaluate the effects of modifications of the present technique of monopolar diathermy tonsillectomy on the incidence of post operative bleeding and compare them with international data for tonsillectomies done without modifications. This is a prospective, longitudinal experimental study. Fifteen hundred patients were studied from January 2000 to January 2008. Patient's age ranged from five to fifteen years. All patients underwent tonsillectomies by modified monopolar diathermy method. The incidence of postoperative bleeding was assessed. Two patients developed significant secondary haemorrhage, which is defined as requiring a return to the operating theater for the control of bleeding. One patient with secondary bleed required blood transfusion in addition to a return to the operating theater. Five patients developed minor secondary bleed that was controlled by conservative means. Two patients developed reactionary bleeding that was controlled in the operating room before return of the patient to the bed. Modifications in the existing technique produces a significantly lower incidence of post operative bleeding from the tonsillar fossae and compares well than those reported in the international literature

Comparison of sub mucosal diathermy and partial resection of Inferior turbinate in the treatment of symptomatic nasal valve blockage.

OBJECTIVES: to evaluate the efficacy of sub mucosal diathermy (SMD) and partial resection of inferior turbinate (PRIT) in the treatment of symptomatic enlarged inferior turbinates. STUDY DESIGN: prospective. METHODS: Forty patients of age group 18 -56 yrs with symptomatic enlarged inferior turbinates had given choices for SMD and PRIT. All the patients had history of failed medical treatment. RESULTS: Each twenty patients underwent SMD (group I), PRIT (group II), five pt of gr. I had to have anterior nasal packing after surgery for bleeding. Three pt complained of excessive rhinorrhoea for first 2 weeks while 3 pt of Group 1 complained of nasal blockage for 1 week even after intervention. In group 2, 5 pt had to have re-anterior nasal packing after pack removal. Both groups followed up for 6 months. Nine patients were lost in follow up, so excluded from the study. Following 6 months of follow up, 6 patient of gr. I had recurrence with nasal blockage and in gr. II none had recurrence. CONCLUSION: PRIT is better than SMD in long course; nevertheless it should be reserved for failed SMD, not as a primary option.

Radiofrequency capsulotomy

To evaluate radiofrequency diathermy as a new technique that cut the anterior lens capsule in cataract surgery. Eighty eyes of eighty patients that had cataract were subjected to controlled circular anterior capsulotomy. The anterior chamber was filled with viscoelastic. The anterior capsule was cut in circular manner [5.5-6.5 mm in diameter] by probe tip heated to 130-160 C by modulated high frequency current of 500 KHz. Very fine irregularities in capsular edge was present nearly in all cases, capsular tears during nucleus expression was present in 8.75% of eyes, during irrigation aspiration additional capsular tears developed in 10% of eyes. Vitreous loss occurred in 5%. Postoperatively malposition of IOL in those who were implanted occurred in 15%. Radiofrequency capsulotomy is an easy technique that produces a controlled size and shape of anterior capsulotomy. The technique rely neither on presence of red reflex nor the elasticity of lens capsule; so it can be a useful technique where the conditions are unfavorable for continuous tear circular capsulorhexis

Punctate diathermy of the soft palate in snorers

To find out the effect of punctate diathermy of the soft palate in management of snoring. A prospective study of 50 consecutive patients of snoring admitted for management. ENT Unit, Hospitals, attached to Medical College, Bikaner and to Medical College, Kota Rajasthan Stale of India. Fifty patients of simple snoring clinically assessed and graded according to type and severity of snoring. Cured, improved or unchanged by the employed procedure in management. Thirty three patients with simple nonapnoeic snoring of grade II to IV were managed by punctate diathermy of soft palate. Twenty two [66.66%] cured and eight patients showed improvement while three [9.9%] remained unchanged. Punctate diathermy of soft palate results in stiffening of musculature, without comprising its function. Conclusions: Punctate diathermy of the soft palate is being found to be a simple, safe and alternate procedure to clinical surgery [UPPP] in management of simple, less severe non-apnoeic cases of snoring

comparative study of diathermy and dissection tonsillectomy

500 cases were subjected to diathermy tonsillectomy between June to December 1992-1996. Comparison between diathermy and dissection method was evaluated by performing diathermy tonsillectomy on one side and dissection method on the other side of a patient as a control. Evaluation was done with reference to intra operative bleeding, operating time, post operative haemorrhage and the post operative pain. Intra-operative bleeding was 10 ml with diathermy method and 33 ml with dissection method on an average. Average operative time was 8 minutes with diathermy and 15 minutes with dissection. Pain was felt equivocally in 350 of the cases. Diathermy tonsillectomy was particularly useful in adults

Diathermy hemostasis versus ligatures of the bleeding points at tonsillectomy

This study included 90 inpatients in E.N.T. Department of Banha University Hospital. Tonsillectomy by dissection under general anesthesia had been performed for these patients using diathermy hemostasis for the right tonsils and ligatures of the bleeding points for the left side. The study concluded that the diathermy hemostasis is time-saving procedure while there was no difference as regards, blood loss and postoperative pain and postoperative hemorrhage

Anterior turbinectomy versus submucous diathermy of inferior turbinate rhinomanometric study

Sixteen patients with chronic hypertrophic rhinitis complaining of bilateral nasal obstruction were classified into two groups.Group 1: Underwent bilateral anterior turbinectomy.Group 11: Underwent submucous diathermy of the inferior turbinate.All patients were evaluiated by anterior Rhinomanometry preoperatively and 2 months. 4 months post operatively 2 months post operatively and data revealed significant improvement of the nasal air way resistance in both groups. After 4 months Group I still showed improventent. While Group 11 showed increased nasal airway resistance. The results show that anterior turbinectomy in better than submncous diathermy in alleviating nasal obstruction in patients with hypertrophied inferior turbinates

Comparative study and evaluation of tonsillectomy operation by dissection and by diathermy knife

Sixty patients were selected to benefit from tonsillectomy. Thirty of them were operated upon by the dissection method and the other thirty patients by diathermy. It was found that diathermy is preferred in decreasing the operation time and the intraoperative blood loss, but the reactionary hemorrhage is more prevalent, secondary hemorrhage is equal in both methods, trauma to mucosa and pillars in case of diathermy occurred only in the initial cases, which means that training decrease the percentage of trauma