Conventional tonsillectomy and bipolar tonsillectomy are the common techniques used in paediatric population with different indications. Our purpose in this study is to offer a comparative evaluation of the intraoperative and postoperative effects of these techniques in paediatric patients.

Aim: To study the effectiveness of electro dissection technique using bipolar diathermy in children undergoing tonsillectomy, interms of intraoperative time, blood loss, post operative pain and post operative complications  like reactionary and secondary haemorrhage.

Materials and Methods: Study is based on the analysis of 50 patients who underwent tonsillectomy between October 2017 to September 2019 at Rajah Muthiah Medical College Hospital, Chidambaram. 50 children were divided into Group A and Group B containing 25 children in each group. The Tonsillectomy was performed under General Anaesthesia. Group A children  underwent tonsillectomy by Dissection and Snare method and Group B children will be underwent tonsillectomy by Bipolar Diathermy method.

Results: The total mean operative time for bipolar diathermy method was 45.12±9.42 minutes and the mean operative time for the dissection and snare was 69.64 minutes±23.31 minutes. The mean intraoperative blood loss for dissection and snare was 59.60±14.02 ml and for bipolar diathermy method, the mean intra operative blood loss was 39.36±6.39 ml. The post operative pain assessed using VAS showed that the pain was more in the Bipolar Group (Group B) from Day 0 to Day 5. However, there was not much difference in post operative pain in the 2 groups on Day6, Day7&Day14. In our study we encountered 1 primary haemorrhage in the dissection and snare method and none on bipolar diathermy method. There were 1 secondary haemorrhage in dissection and snare method and there was 4 secondary haemorrhage in bipolar diathermy method.

Conclusion: Bipolar electrocautery tonsillectomy is a favourable technique in view of ease of the procedure, lesser operative time and less intraoperative blood loss. However dissection and snare tonsillectomy, it is a time tested technique with less post operative pain and morbidity, hence more acceptable to the patient.

Keywords: Tonsillectomy, dissection and snare, bipolar diathermy.

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Dr Ruta Shanmugam

Professor, Dept of ENT, RMMCH, Annamalai University, Chidambaram