Letter to the Editor
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Otorhinolaryngol. Feb 28, 2023; 10(1): 1-3
Published online Feb 28, 2023. doi: 10.5319/wjo.v10.i1.1
Examining the life-cycle of the Coblator II device: Increases in paediatric post-tonsillectomy haemorrhage after six years of use
Ryan Winters, Kimsey H Rodriguez
Ryan Winters, Department of Otorhinolaryngology-Head & Neck Surgery, NSW Health/John Hunter Hospital, New Lambton Heights 2305, NSW, Australia
Kimsey H Rodriguez, Department of Otolaryngology-Head & Neck Surgery, Ochsner Medical Center, New Orleans, LA 70121, United States
Author contributions: All authors participated in experimental design, patient care/protocol application, and manuscript preparation and review.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ryan Winters, MD, Associate Professor, Department of Otorhinolaryngology-Head & Neck Surgery, NSW Health/John Hunter Hospital, Lookout Road, New Lambton Heights 2305, NSW, Australia. ryan.winters@health.nsw.gov.au
Received: November 28, 2022
Peer-review started: November 28, 2022
First decision: January 3, 2023
Revised: January 4, 2023
Accepted: February 10, 2023
Article in press: February 10, 2023
Published online: February 28, 2023
Processing time: 92 Days and 0.9 Hours
Abstract

All paediatric tonsillectomies were examined from 2012 – 2019 at a single tertiary-referral institution, and all were performed by one of two paediatric otolaryngologists. One exclusively used the diathermy, the other exclusively used the Coblator II. Two Coblator units were purchased simultaneously in 2012 and not replaced. There was no significant difference in number of tonsillectomies performed (1298 via diathermy, 1221 via Coblator), nor in postoperative day of bleed, patient age, indication for procedure, and no patient had an underlying coagulopathy. The most common indication for tonsillectomy in both groups was sleep-disordered breathing. There was no significant difference in postoperative haemorrhage rates between groups for the first six years of the study (0%-1.4%/year). Years 7 and 8 saw the Coblator group haemorrhage rate significantly increase (0%-0.6% diathermy group vs 2%-3% Coblator group), though still fell within accepted rate of postoperative haemorrhage. The devices were then replaced, and the differences in haemorrhage disappeared. There appears to be a significant increase in paediatric post-tonsillectomy haemorrhage when using a Coblator device greater than six years old. This may suggest a useful lifespan for the Coblator II device.

Keywords: Tonsillectomy; Paediatric; Post-operative; Haemorrhage; Diathermy; Coblator

Core Tip: There appears to be a significant increase in paediatric post-tonsillectomy haemorrhage when using a coblator device greater than six years old.