Modified Monopolar Tonsillectomy bests coblation technique in tonsillectomy

Written By :  Aditi
Medically Reviewed By :  Dr. Kamal Kant Kohli
Published On 2023-06-11 14:30 GMT   |   Update On 2023-06-12 05:23 GMT
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A research article entitled ''A comparison of coblation and modified monopolar tonsillectomy in adults'' by lead researcher Zhengcai Lou published in BMC Surgery has explained a detailed comparison of modified monopolar tonsillectomy and coblation technique. They said that though the modified monopolar technique might cause more pain on days 1 and 2 after surgery, it offers significant advantages like reducing operation time, secondary PTH and costs.

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According to them, to prevent PTH, dissection of the tonsil should not extend beyond the dense fibrous connective tissue between the inferior pole capsule and lingua.

The tonsillectomy is one of the most widely conducted otolaryngologic surgeries. There is no universally accepted consensus regarding the use of surgical instruments.

In this study, researchers compared the intraoperative records and postoperative clinical outcomes of adults who underwent coblation and modified monopolar tonsillectomy tonsillectomies.

The researchers divided adult patients with tonsillectomy into the coblation and modified monopolar tonsillectomy groups and compared estimated blood loss, postoperative pain score, operation time, post-tonsillectomy hemorrhage (PTH), and cost of disposable equipment.

The crucial insights from the study include the following:

  • There were 653 patients in the age range of 18–46 years.
  • Both groups had similar pain intensity on postoperative days 3 and 7.
  • There was a higher mean maximum pain score in the monopolar group than the coblation group on postoperative days 1 and 2.
  • In the coblation and monopolar group, Secondary PTH occurred in 7.1% and 2.8% (9/327) of patients.
  • In the coblation and monopolar group, there was Uvula-significant oedema in 39.3% and 85.4%.
  • The monopolar group had a shorter mean operation time.
  • The cost of the disposable equipment 18 in the coblation and monopolar groups was US$ 430.48 and US$ 28. Respectively.

They said pain significantly increased on postoperative days 1 and 2 in the modified monopolar tonsillectomy group, and the operation time, secondary PTH, and medical costs were significantly decreased compared to the coblation technique group.

Further reading:

Lou, Z. A comparison of coblation and modified monopolar tonsillectomy in adults. BMC Surg 23, 141 (2023). https://doi.org/10.1186/s12893-023-02035-1

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Article Source : BMC Surgery

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