Background and Objective:
Tonsillectomy is one of the oldest and most common head and neck surgeries. Many techniques employed for tonsillectomy include: Cold Dissection (with metal instruments; Cold knife and Snare) and Hot Dissection (electrosurgery, coblation, harmonic ultrasonic scalpel). Postoperative pain and bleeding are the most common complication of tonsillectomy. Cold Dissection employed for tonsil removal and cannot stop bleeding. Electrocautery must be used as a supplementary measure to control rapid bleeding. Nevertheless, Electrocautery causes collateral tissue damage around the bleeding site.
Coblation is a popular hot method. However, the superiority of coblation is unproven and different results were reported in studies. The aim of this review was to compare the effects of coblation tonsillectomy with other surgical techniques on intraoperative and postoperative morbidity.Search Method: The search of the literature was conducted in PubMed; Google Scholar; Web of Science and Science Direct databases using English terms Coblation, tonsillectomy, bleeding, and Postoperative pain during 2000-2019. Selection criteria include Randomized controlled trials of children and adults undergoing elective tonsillectomy with coblation compared with other surgical technique. Findings: We identified 1234 records by database searching through 2000-2019. From these, 29 relevant studies were included in review. The review showed that, mean time to remove tonsil with coblation and electrocautery was 8.22 minutes and 6.33 minutes, respectively (P =.011). Mean intraoperative blood loss for each technique was less than 10 ml. Postoperative pain was significantly less with coblation as compared with electrocautery. Postoperative hemorrhage rates and wound healing were not significantly different between two techniques.Conclusion: Knowledge of mechanisms and different methods of dissection and hemostatic in tonsillectomy surgeries can help operating room nurses and surgeons to minimize catastrophic complications.
Coblation tonsillectomy was less painful and less heat than electrocautery.