Diathermy Technique Research Articles

Safety and Efficacy of Hook Diathermy in the Dissection of the Mesocolorectum During Laparoscopic-Assisted Pull-Through for Hirschsprung Disease in Low-Resource Settings.

Background: Surgical correction is the main line of treatment for the congenital disorder Hirschsprung's disease (HD). Laparoscopic techniques proved their safety and efficacy in previous studies. LigaSure™ is the gold standard for colorectal dissection. However, other sealing methods could be used during the unavailability of LigaSure. Purpose: This study aimed to assess the safety profile of the hook diathermy technique compared to LigaSure in colorectal dissection during laparoscopic-assisted pull-through for HD. Materials and Methods: This case-control study was held in the pediatric surgery department at Assiut University Hospitals between September 2017 and January 2023. The study included 57 HD patients who were surgically operated on during a laparoscopic-assisted pull-through. They were divided into 2 groups according to the sealing methods: the ligasure group included 25 patients, and the hook diathermy group included 32 patients. Results: Both groups had no statistically significant differences regarding age, sex, or weight. The transition zone was present in all patients, and most transition zones were rectosigmoid. No cases reported intraoperative blood transfusion or conversion to an open or transanal approach. Minimum intraoperative blood loss was reported in both groups, with no significant differences. As regards postoperative complications, including bleeding, leakage, perianal excoriation, and enterocolitis, no significant differences between both groups were found. Conclusion: The LigaSure and hook diathermy techniques are safe and effective sealing methods for colorectal dissection during laparoscopic-assisted pull-through for HD.

Diathermy versus surgical technique methods of adenotonsillectomy and its effect on voice in children

Diathermy versus surgical technique methods of adenotonsillectomy and its effect on voice in children

Comparison of Bipolar Diathermy and Suture Ligation for Haemostasis in Tonsillectomy

Objective: To compare bipolar diathermy and suture ligation for haemostasis in tonsillectomy in terms of the amount of blood loss, number of ligatures applied, average time taken and incidence of postoperative haemorrhage. Study Design: Randomized controlled trial Place and Duration of Study: Multicenter study conducted in ENT Surgery Departments/Units of Public and Private Sector Hospitals of Lahore from 1st July 2017 to 31st July 2018. Methodology: Sixty six patients were enrolled. Informed consent and demographic information was takenfrom all the patients. Patient himself was the control and the trial. One tonsil was treated with ligation technique (Group A) and other with bipolar diathermy technique (Group B). Both the tonsil side and the technique were randomized. The outcome in both groups was noted. Results: The mean age was 12.39±7.41 years and male to female ratio was 0.8:1. The mean haemostasis time in group A was 14.32±2.81 minutes whereas in group B patients it was 10.62±1.76 minutes. The mean blood loss in group A patients was 42.82±13.360 ml whereas in group B patients was 28.015±8.619 ml. The incidence of post-operative haemorrhage was zero for both bipolar diathermy and suture ligation, which shows the safety of both procedures. Conclusion: Bipolar diathermy is safe, effective, easier and faster technique for haemostasis in tonsillectomy than ligation technique Keywords: Tonsillectomy, Bipolar Diathermy, Ligation Technique

Outcome comparison of submucous resection versus combined submucous diathermy and outfracture for treatment of inferior turbinate hypertrophy.

The aim of this study was to compare the outcome of submucous resection and combined submucous diathermy with outfracture technique in treatment of nasal obstruction caused by inferior turbinate hypertrophy. This study is a prospective randomized clinical trial involving 90 patients with hypertrophied inferior turbinate not responding to medical treatment. All patients were selected with equal or near equal mucosal and bony turbinate components using computed tomography (CT) and then randomly allocated into two groups; group A (n = 45): underwent submucous resection in both sides and group B (n = 45): underwent combined submucous diathermy and outfracture in both sides. Subjective (NOSE score) and objective (4-grades endoscopic classification system and PNIF evaluation) measures of nasal airflow were done preoperatively and postoperatively. Subjective assessment using NOSE scale proved that both techniques were effective in relieving nasal obstruction as it improved in both groups postoperatively compared to the preoperative data. However, resection technique was better than diathermy technique with a statistically significant difference (p < 0.05), while objective assessment of nasal obstruction showed better results in resection group than diathermy group, but with no statistically significant difference. Both techniques are effective in relief of nasal obstruction due to inferior turbinate hypertrophy. However, submucous resection showed marked improvement compared to diathermy technique especially at long-term follow-up.

Bipolar loop device versus bipolar diathermy for tonsillectomy: A pilot randomized controlled trial

ObjectiveTonsillectomy is one of the most common surgeries performed in the pediatric population. Although different forms of instruments and various methods are used to perform tonsillectomy, none of them is still recognized as the best global technique. This study aimed to compare the outcomes of the new Bipolar Loop tonsillectomy versus bipolar diathermy technique. MethodsThis study is a pilot randomized clinical trial and was conducted on 40 pediatric patients who were the candidate of tonsillectomy. Patients were divided into two groups of Bipolar Loop or bipolar diathermy. Operation time, intraoperative bleeding, tonsillar fossa wound, postoperative complications, and duration of return to normal diet were evaluated in the current study. ResultsIn both of the Bipolar Loop and bipolar diathermy groups, no significant difference was found in terms of sex, age, and weight. The average amount of the operative time, intra-operative blood loss, and postoperative pain loss were significantly less in the Bipolar Loop group (P < .001). In addition, the tonsillar fossa wound healing scores were significantly better (on the 14th day, P = 0.009). However, there was no significant difference between the two groups in terms of postoperative bleeding, duration of return to a normal diet, and postoperative symptoms of fever, otalgia, or voice change between the groups. ConclusionThe study showed that blood loss and postoperative pain through day 7 were significantly less in the Bipolar Loop group. Tonsillectomy with Bipolar Loop can be recommended as one of the methods for tonsillectomy, especially in pediatric patients.

A comparative study between dissection and diathermy tonsillectomy

Background: Tonsillitis is a rapid onset inflammation of the tonsils. It is associated with sore throat, fever, enlargement of the tonsils, trouble swallowing and large lymph nodes around the neck. Dissection and diathermytonsillectomy are two trusted methods in the treatment of tonsillitis. We have a few comparative information between these two methods. Aim of the study: The aim of this study was to dig out a comparative evaluation between dissection and diathermy method in treating tonsillitis. Materials and Methods: This prospective cross-sectional study was conducted in the Department of ENT Dhaka, in a tertiary care hospital of Dhaka, Bangladesh during the period from January 2017 to December 2019. In total 176 patients of several ages with tonsillitis required dissection and diathermytonsillectomy were finalized as the study population. Among total participants in group I, in 109 dissection procedure were applied whereas in group II in the rest 67 diathermy method were applied. All the data were processed by using SPSS version 22.0 Results: In both the groups the mean hospital staying duration was the same and it was 1 day (SD± 0.31). Between both the groups 5% (n=9) participants of group I faced secondary infection and post-operative complication which was 38.89% in Group II. In this study per-operative blood loss for dissection method of tonsillectomy ranged from50 ml to 100 ml, with the average being 65 ml. On the other hand, per-operative blood loss for diathermy tonsillectomies ranged from 10 to 30 ml, with the average being 10 ml. In dissection-method, needed average time was 26.6 minutes whereas in diathermy procedures it was 15.5 minutes. Conclusion: Although post-operative bleeding, pain, fever and secondary infections are the complications of both techniques and have similar incidences the intra-operative blood loss and time are two important factors that can affect the outcome of both techniques. Considering these, we found that, the dissection is a more effective and safer method than diathermy technique regarding secondary infection.

ADENOIDECTOMY BY DIFFERENT TECHNIQUES (COMPARATIVE STUDY)

Background: Adenoidectomy is one of the most common pediatric ambulatory procedure in the world, multiple techniques are present for adenoidectomy with relative advantages and dis advantages of each technique. Objectives: Providing a comparative study of adenoidectomy by electrocautary with suction diathermy, conventional and microdebrider techniques. Patients and Methods: Randomized prospective study included 60 child patients with age ranged from (3-12y) of both genders (28 males and 32 females), all suffering from hypertrophied adenoid tissue, presented clinically with mouth breathing, snoring, partial nasal obstruction and/or discharge and evidenced radiologically with plain X-ray film lateral view to the nasopharynx. All cases presented to Al-Azhar University Hospitals (Al-Hussin & Sayed galal) during the period from July 2018 to December 2018. Results: The mean blood loss in suction diathermy technique was (5.56ml) while in conventional and microdebrider techniques were 43.45ml and 31.90ml respectively and this found to be of highly statistical significance. Also in complete of removal of adenoid tissue there were significant statistical difference between conventional and microdebrider (p-value:0.02) also between conventional technique and suction diathermy technique (p-value < 0.03) but as regard operative time there was highly significant statistical difference between conventional and microdebrider (p-value < 0.001). Conclusion: The suction diathermy adenoidectomy is the technique of choice in lowering intraoperative blood loss compared to other tow techniques, also sharing microdebrider technique in visibility of the surgical field and completeness of resection, when the cost and availability are affordable it will be the gold standard technique for adenoidectomy, the conventional technique have a disadvantages of bleeding, traumatic and incomplete of resection but still cheapest, simplest and most available one.

Estimation of Coagulation Profile and Platelet Counts in Type 2 Diabetic Patients

Background: Adenoidectomy is one of the most common pediatric ambulatory procedure in the world, multiple techniques are present for adenoidectomy with relative advantages and dis advantages of each technique. Objectives: Providing a comparative study of adenoidectomy by electrocautary with suction diathermy, conventional and microdebrider techniques. Patients and Methods: Randomized prospective study included 60 child patients with age ranged from (3-12y) of both genders (28 males and 32 females), all suffering from hypertrophied adenoid tissue, presented clinically with mouth breathing, snoring, partial nasal obstruction and/or discharge and evidenced radiologically with plain X-ray film lateral view to the nasopharynx. All cases presented to Al-Azhar University Hospitals (Al-Hussin & Sayed galal) during the period from July 2018 to December 2018. Results: The mean blood loss in suction diathermy technique was (5.56ml) while in conventional and microdebrider techniques were 43.45ml and 31.90ml respectively and this found to be of highly statistical significance. Also in complete of removal of adenoid tissue there were significant statistical difference between conventional and microdebrider (p-value:0.02) also between conventional technique and suction diathermy technique (p-value < 0.03) but as regard operative time there was highly significant statistical difference between conventional and microdebrider (p-value < 0.001). Conclusion: The suction diathermy adenoidectomy is the technique of choice in lowering intraoperative blood loss compared to other tow techniques, also sharing microdebrider technique in visibility of the surgical field and completeness of resection, when the cost and availability are affordable it will be the gold standard technique for adenoidectomy, the conventional technique have a disadvantages of bleeding, traumatic and incomplete of resection but still cheapest, simplest and most available one.

May radiofrequency be the best choice for III-IV degree hemorrhoids?

Hemorrhoidectomy is considered the most efficient method to treat hemorrhoids of III and IV grades. The aim of this study was to compare conventional diathermy hemorrhoidectomy and radiofrequency hemorrhoidectomy based on a large series of patients. Between June 2001 and June 2014, 1000 patients have been treated with radiofrequency hemorrhoidectomy (group A) and 500 patients have been treated with diathermy (group B) as a day-case procedure. Operating time, postoperative pain score, hospital stay, early and late postoperative complications, wound healing time and time to return to normal activities were assessed. The mean follow-up was seven years. The mean operating time for radiofrequency hemorrhoidectomy was shorter than diathermy but not significantly. Patients treated with radiofrequency had significantly less postoperative pain (measured on a Visual Analogue Scale; P=0.001), a shorter wound healing time, less time off work and postoperative complications (P=0.001) than patients who had diathermy. Neither wound healing nor mean hospital stay (day-case surgery) was significantly different. Radiofrequency hemorrhoidectomyis a valid alternative to the conventional diathermy technique, due to the reduction of operative time, postoperative pain, early and late complication rate.

Post-tonsillectomy hemorrhage after bipolar diathermy vs. cold dissection surgical techniques in Alahsa region, Saudi Arabia

IntroductionTonsillectomy is a common surgical procedure done by otolaryngologists. Tonsillectomy is a relatively simple procedure. The concept of implementing it as a day case operation has become increasingly popular. Material and MethodsThis is a cross sectional study done in Alahsa city, eastern province, Saudi Arabia during the period from January 2014 to March 2015,This study reported the postoperative hemorrhage after Bipolar diathermy and Cold dissection surgical techniques to evaluate the incidence of the hemorrhage and to identify the possible risk factors associated with its occurrence. ResultsPostoperative bleeding occurred in 45 (3.6%) out of 1232 patients. Post-tonsillectomy hemorrhage according to operation technique was significantly higher among patients who underwent bipolar diathermy than cold dissection technique (p<0.05). ConclusionBleeding after operation by bipolar diathermy technique was occurring more frequently within the first five days. Hemoglobin level was significantly decreased in post-tonsillectomy hemorrhage.

Comparison of three techniques for tonsillectomy during free medical camps in Yemen

Abstract The aim of the study was to compare four different surgical techniques for tonsillectomy during free medical camps in Yemen, regarding type of anesthesia, complication rates, operative time, and cost of the operation. This prospective study was conducted from April 2006 to December 2011. There were 12 280 patients who underwent tonsillectomy in 26 hospitals in different Yemeni governorates, and operations were performed in 46 free medical camps. Under general anesthesia, we performed traditional dissection techniques (TDTs) and bipolar diathermy technique. Under local anesthesia, tonsillectomies were performed using TDT and guillotine excision technique. Of the 12 280 tonsillectomies patients, 53.7% were male patients and 46.3% were female patients. The median age of the patients was 11.5 years (range 3–30 years). Under general anesthesia, 6639 (54.1%) tonsillectomies were performed; of these, 86.1% were performed by TDT, whereas 13.9% were performed by bipolar diathermy technique. Under local anesthesia, 5641 (45.9%) tonsillectomies were performed; of these, 81% were performed by TDT, whereas 19% were performed by guillotine excision technique. Post-tonsillectomy hemorrhage was low in patients operated by TDT as compared with the other techniques. No significant differences were found in operative time between the four surgical techniques. The costs of tonsillectomy ranged between 30 and 37$. The TDT is the most common method performed in the free medical camps, is handy, favorite, less costly, and comfortable for our patients, and is suitable for our work environments, experiences, and equipments. We recommend this technique for the same circumstances as a day-case tonsillectomy. Although less postoperative hemorrhage was observed in traditional surgery under general anesthesia, surgery under local anesthesia is safer and less costly.

Adult bipolar diathermy circumcision and related procedures in adults - a safe and efficient technique.

ObjectivesTo present our novel technique and step-by-step approach to bipolar diathermy circumcision and related procedures in adult males.MethodsWe reviewed our technique of bipolar circumcision and related procedures in 54 cases over a 22-month period at our day procedure center. Bipolar diathermy cutting and hemostasis was performed using bipolar forceps with a Valleylab machine set at 15. Sleeve circumcision was used. A dorsal slit was made, followed by frenulum release and ventral slit, and was completed with bilateral circumferential cutting. Frenuloplasties released the frenulum. Preputioplasties used multiple 2–3 mm longitudinal cuts to release the constriction, with frenulum left intact. All wounds were closed with interrupted 4/0 Vicryl Rapide™.ResultsA total of 54 nonemergency bipolar circumcision procedures were carried out from November 2010–August 2012 (42 circumcisions, eight frenuloplasties, and four preputioplasties). Patients were aged 18–72 years (mean, 34 years). There was minimal to no intraoperative bleeding in all cases, allowing for precise dissection. All patients were requested to attend outpatient reviews; three frenuloplasty and two circumcision patients failed to return. Of the remaining 49, mean interval to review was 49 days, with a range of 9–121 days. Two circumcision patients reported mild bleeding with nocturnal erections within a week postoperatively, but they did not require medical attention. Two others presented to family practitioners with possible wound infections which resolved with oral antibiotics. All 49 patients had well-healed wounds.ConclusionThe bipolar diathermy technique is a simple procedure, easily taught, and reproducible. It is associated with minimal bleeding, is safe and efficient, uses routine operating equipment and is universally applicable to circumcision/frenuloplasty/preputioplasty. In addition, it has minimal postoperative complications, and has associated excellent cosmesis.

Management of third branchial pouch anomalies – An evolution of a minimally invasive technique

ObjectivesThe management of third branchial pouch anomalies has evolved in recent times with the popularisation of the endoscopic diathermy technique to sclerose the pyriform fossa sinus opening. We present our experience in managing 3 children with third branchial pouch anomalies and propose a minimally invasive management algorithm avoiding open neck surgery. MethodsRetrospective case review of 3 patients including demographics, mode of presentation, investigations, management and complications. ResultsThree children, two male and one female of mean age 9.6 years presented with painful left anterior neck swelling. Axial neck imaging showed a superficial abscess with air locules and a sinus tract leading towards the left pharynx. Diagnosis was confirmed by endoscopic examination of the pyriform fossa revealing a sinus opening. Two patients underwent open excision; one combined with diathermy to the sinus opening. The last patient was diagnosed at his initial presentation and managed with endoscopic diathermy of the sinus opening combined with percutaneous needle aspiration of the neck abscess at the same sitting. One patient had two recurrences, the first after initial open surgery and the second after the first cautery. Two patients developed temporary hoarseness after the procedure, which resolved within two weeks. All patients were free from recurrences at follow-up. ConclusionsIntroduction of the technique of endoscopic diathermy to the pyriform fossa sinus opening in children with third branchial pouch anomalies has revolutionised their management avoiding open and potentially morbid surgery. Our algorithm takes this further by advocating percutaneous needle aspiration of the infective component and performing diathermy to the sinus opening at the first presentation.

Endoscopic Diathermy-assisted DCR: A New Concept

ABSTRACT Endoscopic diathermy-assisted technique is very safe, quick, less traumatic, with minimal blood loss, less tissue scarring and less postoperative discomfort and last but not the least, the ease of creating big size ostium. It has high success rate in both primary and secondary cases. Fifty-four cases of chronic dacryocystitis were treated by the endoscopic diathermy technique including 42 females and 12 males with mean age 34.66 years, 38 left eye and 16 right eye. Four patients were cannulated with nasolacrimal tube with very good results and few complications. How to cite this article Shubhrica, Ranga RK. Endoscopic Diathermy-assisted DCR: A New Concept. Clin Rhinol An Int J 2013;6(2):88-91.

Post-tonsillectomy hemorrhage in children: a single surgeon’s experience with coblation compared to diathermy

The aim of this study was to compare coblation and diathermy techniques with respect to secondary post-tonsillectomy hemorrhage (PTH). A total of 1,397 children underwent tonsillectomies with or without adenoidectomy by a single surgeon in a single center from June 2005 through December 2011. A diathermy tonsillectomy was performed on 315 patients for the first 2 years, while a coblation tonsillectomy was performed on 1,082 for the next 5 years. All patients were followed-up within 28 days of surgery by the same surgeon. The characteristics of primary and secondary PTH were analyzed with a retrospective chart review. Primary PTH did not occur in both surgical technique groups. Secondary PTH occurred in 9 patients (2.9 %) in the diathermy group and in 30 patients (2.8 %) in the coblation group. The secondary PTH rates were 1.2, 2.5, 3.8, 3.1 and 4.5 % in the first, second, third, fourth and fifth years after employment of the coblation tonsillectomy, respectively (P = 0.243). Sex, age, tonsil size and severity of tonsillar embedding were not significant factors for PTH. The coblation technique was associated more with late secondary PTH than diathermy technique (odds ratio 9.14, P = 0.049). Analysis of the time of onset of PTH showed that secondary PTH occurred most commonly between 6 p.m. and 6 a.m. In summary, coblation technique has similar secondary PTH rate with diathermy technique although it has increased late secondary PTH rate in children. Coblation technique can be a good alternative to the diathermy technique.

Penile resurfacing for denuded penis following circumcision

Major loss of penile shaft skin following circumcision has been rarely reported in the paediatric literature and when it occurs is usually due to the injudicious use of monopolar diathermy, infection and poor surgical technique. We report the reconstruction of a penis following complete loss of penile skin due to circumcision. We employed a split-skin graft for the glans and full-thickness graft for the shaft to achieve a more natural cosmetic appearance. This approach has not been described previously in the paediatric literature and should be considered in the unfortunate event of significant penile skin loss.

Adenoidectomy Technique in the United Kingdom and Postoperative Hemorrhage

To investigate the incidence of postoperative hemorrhage and its risk factors after adenotonsillectomy. A prospective cohort study as part of the National Prospective Tonsillectomy Audit. National Health Service and private hospitals in England and Northern Ireland. National Prospective Tonsillectomy Audit methodology was followed with a nonrandomized prospective observational cohort methodology and data collection. A total of 33,921 patients underwent tonsillectomy; of these, 9900 underwent adjunctive adenoidectomy. Traditional curette adenoidectomy (without any diathermy use at all) was performed in 6871 patients. Suction diathermy technique was used in 1489 patients. Hemorrhage rates were calculated for these main adenoidectomy technique groups and compared by calculation of risk ratios. Both early and late hemorrhage rates for suction diathermy were found to be 0.07% (n = 1 in each case). In the traditional curette group, these rates were 0.3% (n = 19) and 0.2% (n = 14), respectively. The risk ratio for hemorrhage overall was 3.6 for curette adenoidectomy compared with suction diathermy (95% confidence interval, 0.86-14.9; P = .06). The data suggest comparable hemorrhage rates in both adenoidectomy technique groups and fail to demonstrate diathermy usage as a risk factor for hemorrhage following adenoidectomy despite a clear interaction between diathermy usage and subsequent hemorrhage in tonsillectomy. Use of suction diathermy in adenoidectomy appears to have a similar safety profile to conventional techniques and may offer additional benefits over traditional adenoid curettage. Further clinical and laboratory-based research into the complex interaction between diathermy usage and both adenoid and tonsillar tissue is warranted.

A Modification of the Uterine Artery Restriction Technique in the Guinea Pig Fetus Produces Asymmetrical Ultrasound Growth

Aims To evaluate the use of diathermy ablation of branches of the uterine artery to produce growth restriction in the fetal guinea pig, and to compare this new approach with the more conventional use of uterine artery ligation. The development of growth restriction was documented by measuring fetal biparietal diameter (BPD) and the resistance index (RI) of the umbilical artery blood flow velocity waveform. Methods At 30–35 days of gestation (term = 70 days), one uterine artery was ligated in 29 sows. In another 16 sows, branches of one uterine artery were ablated using diathermy. Fetuses in contralateral horns were used as controls. Ultrasound measurements were made weekly, and at 59–69 days of gestation animals were euthanased to determine fetal position in utero as well as fetal and placental weights. In some fetuses, brain and liver weights were also recorded. Results Both surgical techniques resulted in similar reductions in fetal body and placental weights. The number of fetuses surviving to term was greater in the diathermy group (53%) compared to the ligation group (22%) ( P < 0.05). Results from these two groups were combined and referred to as “treated” fetuses. The brain/liver weight ratio was increased by 245% in the treated fetuses compared to control fetuses. Ultrasound measures of BPD in the treated fetuses were within the normal range. The mean RI of the treated group showed a slight but significant increase near term compared to the mean RI of the normal range. Conclusion We have shown that the diathermy technique produces asymmetrical fetal growth restriction (with normal head size) in the guinea pig to the same extent as the conventional ligation technique. It is associated with a lower fetal mortality rate and therefore should be the preferred method. The minimal increase in umbilical artery resistance index only at the end of gestation amongst the intrauterine growth restriction (IUGR) fetuses suggests that an obliterative vasculopathy in the umbilical circulation is not the cause of growth failure when there is maternal uteroplacental restriction.

Effect of Low Dose Electrocautery Usage during Radial Artery Harvesting on the Neurological Outcome of the Forearm: A Neuroelectrophysiological Study

The present study aimed to investigate whether electrocautery caused any thermal injury to the forearm nerves or not. We compared the neurological outcome of two different radial artery harvesting techniques through neuroelectrophysiological studies. Preoperative values and postoperative conduction changes after one month were compared in two groups of patients. Each of the groups consisted of 20 patients. Radial arteries were harvested using scissors in Group 1 and with a low dose diathermy technique in Group 2. The mean amplitude of sensory action potentials of radial nerves was significantly reduced postoperatively at the end of the first month in both groups (P = 0.01, P = 0.001). But there were no significant differences between groups with respect to the sensory action potentials of ulnar and median nerves postoperatively. There were no significant differences between groups with respect to radial, ulnar and median nerve motor conduction recordings. Low dose electrocautery does not cause excessive nerve injury compared with the scissors technique in radial artery harvesting. Electrocautery may be used safely for RA harvesting in the forearm.

15‐YEAR AUDIT OF POST‐TONSILLECTOMY HAEMORRHAGE AT DUNEDIN HOSPITAL

Post-tonsillectomy haemorrhage is a significant complication because of its frequency and consequences. Increases in post-tonsillectomy haemorrhage prevalence have been reported. There is a controversy about whether increasing the use of diathermy techniques or anti-platelet aggregation effects of analgesia could have caused this increase. We carried out an audit of post-tonsillectomy haemorrhage and examined the rates of readmission for bleeding during the period 1990-2004. We also recorded the surgical technique used and the use of perioperative non-steroidal anti-inflammatory drugs and corticosteroids. During this period there has been a significant increase in post-tonsillectomy haemorrhage with an average annual increase of 15.3% (P<0.0001, 95% confidence interval 8.5-22.5%). The increase is coincidental with the change-over to predominant diathermy technique and a routine use of postoperative non-steroidal anti-inflammatory drugs and steroids.