Comparison between Silk Ligation and Bipolar Cautery in Tonsillectomy

Background: Tonsillectomy is a commonly performed surgical procedure. There are several operative methods but the superiority of one over the other has not been clearly demonstrated. The aim of this study was to compare the morbidity associated with tonsillectomy using two different techniques for hemostasis – silk ligation versus diathermy. Material and Methods: This was an experimental study conducted at ENT Department of Khyber Teaching Hospital Peshawar and Gomal Medical College D.I.Khan, from January 2003 to December 2004. Results of the two groups i.e. tonsillectomy using silk ligation or diathermy for hemostasis were studied. Results: Tonsillectomy of 180 patients was performed; 130 (72.22%) male and 50 (27.77%) female. Bipolar diathermy was used in 60 cases to achieve hemostasis while silk ligation in 120. The mean operation time was 15 minutes with bipolar diathermy as compared to 30 minutes with silk ligation. Analgesia requirement in first 24 hours was equal in both groups. Primary hemorrhage was noticed in 4 (6.66%) cases when hemostasis was achieved using bipolar diathermy and in 8 (6.66%) cases when silk was used. Secondary hemorrhage was noticed in 8 (13.33%) cases with bipolar diathermy as compared to only 5 (4.16%) when silk ligation was done. Conclusion: Less operative time is taken by bipolar diathermy method as compared to the tonsillectomy using silk ligation for hemostasis. Chances of primary hemorrhage are equal but secondary hemorrhage is significantly less with silk ligation.