Post?tonsillectomy hemorrhage in Very?Low Energy Monopolar V
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Very?low energy monopolar technique reduces post?tonsillectomy hemorrhage as compared to standard energy technique, finds a recent study published in The Laryngoscope.

The objective of this study was to compare rates of post?tonsillectomy hemorrhage (PTH) between a very?low energy transfer monopolar technique (VLET) and standard energy techniques.

All tonsillectomies performed by practice physicians during the period January 1, 2010, to August 31, 2019, were identified. Three groups were created based on surgeon technique utilization: the study group (VLET) and two control groups (exclusive standard energy monopolar [Standard]; exclusive “hot” technique without exclusive monopolar use [Mixed “Hot”]). Each group's PTH occurrences requiring surgical intervention (PTHRSI) were identified and rates compared.

During the study period 11,348 tonsillectomies were performed (4,427 Standard, 1,374 VLET, 5,547 Mixed “Hot”), and 167 PTHRSI events identified.

--Compared to the Standard group secondary and total PTHRSI rates, the Mixed “Hot” group experienced similar rates, but the VLET group experienced significantly lower rates.

--Age was a significant risk factor for both secondary and total PTHRSI.

--No significant difference in the rate of primary PTHRSI was seen collectively or in any age group.

--The <12VLET Group experienced 0 episodes of secondary PTHRSI and a total PTHRSI rate of 0.09% in 1060 tonsillectomies.

In conclusion, standard energy techniques had an adjusted odds ratio over 8?fold higher for secondary PTHRSI and over 6?fold higher for total PTHRSI compared to the minimized energy transfer VLET technique.