Ayub Ahmad Khan, Muhammad Umar Aasim, Imran Saeed.
Ultrasonic scalpel tonsillectomy versus cold dissection/electrocautery tonsillectomy: a Pakistani perspective..
Pak Paed J Jan ;36(1):23-6.

The ultrasonic scalpel (US) has been used in tonsil surgery for several years. The comparison of ultrasonic scalpel tonsillectomy with other tonsillectomy techniques has been the subject of many studies. Objectives: The objective of this study was to test whether the use of the ultrasonic scalpel would cause less pain and more rapid recovery in tonsillectomy patients versus the use of combined cold dissection and electrocautery. Design and Settings: In this multicentre study we conducted a prospective non randomized comparison of 200 pediatric tonsillectomy cases. Outcome variables consisted primarily of immediate- and mid-term pain, time to return to normal diet, morbidities, and healing of wound. Results: Patients who were operated with ultrasonic scalpel had less immediate and mid-term pain, started normal diet early however healing of tonsillar fossa was same as compared to the electrocautery group. Complications like primary hemorrhage was more common with harmonic scalpel while secondary hemorrhage and collateral damage was more with cold dissection and electrocautery. Conclusion: The ultrasonic scalpel seems to be a well-designed and easy-to-use instrument. Operating time is short, and the degree of early postoperative pain is low. It may well have a place in the surgical armamentarium for tonsillectomy.

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