Tech Advances for Tonsillectomy Not Necessarily Better

As researchers are finding in many areas of medicine, new and higher tech ways aren't necessarily better than tried and true techniques once they're put to the test. And so it goes with one of the most frequently performed procedures, the tonsillectomy, according to a summary analysis.

As reported in the Archives of Otolaryngology—Head and Neck Surgery, published by the Journal of the American Medical Association, newer coblation and harmonic scalpel (HS) strategies to seal vessels and stop bleeding were not better than conventional cold steel and/or electrocautery dissection (CS/EC).

Tonsillectomies are considered safe, but they are usually accompanied by a lot of post-surgical pain, bleeding, and long convalescence before the patient can return to normal diet and activity levels. 

That's why at least five technological innovations have been developed over the last decade in an effort to minimize those results. "Yet no definite consensus has been reached regarding the optimal technique with the lowest morbidity rates," wrote Vangelis G. Alexiou, MD, of Northampton General Hospital in England, along with co-authors from Tufts University School of Medicine in Boston, and Henry Dunant Hospital in Athens, Greece.

The authors looked at 33 randomized controlled trials that studied 3,139 patients who underwent the surgery in which doctors employed a variety of technologies:

• The LigaSure Vessel Sealing System (VSS)
• The Thermal Welding System
• The BiClamp
• The Harmonic Scalpel
• Radiofrequency ablation or cold ablation, "referred to by the trade name coblation."

The five were compared with conventional techniques, which use cold steel and/or electrocautery dissection.