ABSTRACT
Background: Bipolar electrocautery tonsillectomy has been the preferred technique for many otolaryngologists, yet coblation tonsillectomy is gaining popularity in the current practice. This study aims at comparing both techniques in terms of pain, bleeding, and healing. Result(s): A total of 120 patients were randomly divided into two equal groups. Overall mean pain score associated with coblation tonsillectomy was statistically less than that caused by bipolar electrocautery throughout the follow-up period (p < 0.001). The difference in pain duration was statistically longer for the bipolar group. The incidence of postoperative hemorrhage-both reactionary and secondary-was statistically higher in the bipolar group. Coblation tonsillectomy showed statistically shorter duration of healing (p < 0.001). Conclusion(s): Coblation tonsillectomy is associated with less pain severity and shorter pain duration, fewer bleeding incidents, and more prompt healing.Copyright © 2022, The Author(s).
ABSTRACT
Background: There have been numerous techniques used in laparoscopic appendectomy (LA) to divide the mesoappendix, including LigaSure, Harmonic scalpel, clips, endoloop ligatures, Endo GIA staplers, and bipolar coagulation. However, few studies have investigated monopolar diathermy for mesoappendix division. Therefore, this study aimed to assess both its safety and efficacy in LA. Method(s): In this prospective non-randomized study, patients (n = 87) who underwent LA for acute appendicitis were included. The bipolar electrocautery was used for mesoappendix division in the first 33 patients (BC group), while the monopolar electrocautery was used in the next 54 patients (MC group). Result(s): The median operative time was significantly shorter in the MC group (42 min. vs 47 min. in BE group, p = 0.01). One patient converted to open surgery in the MC group due to uncontrollable bleeding. There were no significant differences between both groups regarding postoperative complications and hospital stay (p = 0.91, p = 0.13, respectively). Conclusion(s): Monopolar electrocautery is safe and effective for mesoappendix division in LP in comparison to bipolar electrocautery. However, larger and multicentric studies are required to validate our results.Copyright © 2023 The Authors
ABSTRACT
OBJECTIVE: To compare the degree of particle aerosolization with the use of several energy devices used in tonsillectomy and other common upper airway procedures. METHODS: Three different energy devices were measured. These included (a) monopolar electrocautery, (b) bipolar electrocautery, and (c) thermal welding device (TWD). Each device was applied to fresh cadaveric cow tongue and porcine nose. Aerosolized particles produced by these devices were measured using a calibrated electronic particle counter. Measurements were recorded over the course of 3 minutes. Particle sizes were measured at 0.3, 0.5, 1.0, 5, and 10 µm. RESULTS: In comparing types of tissues and particle sizes, TWD had the lowest aerosolizing burden among the three devices. By analyzing the highest particle value of TWD against both monopolar and bipolar, monopolar electrocautery proved to have the highest aerosolization exposure with statistical significance at 0.5 and 10 µm. No statistical significance was found when comparing TWD against monopolar electrocautery. DISCUSSION: Our study demonstrates there is a difference in aerosolization burden dependent on the type of device utilized. TWD proved to have the lowest burden whereas monopolar electrocautery had the highest. CONCLUSION: TWD produces less aerosolization than conventional monopolar electrocautery when cauterizing or ablating tissue in an experimental setting. The degree of aerosolization was comparable to bipolar electrocautery. LEVEL OF EVIDENCE: 2.