Effectiveness of the ultrasonic harmonic scalpel for tonsillectomy.

The Ultracision harmonic scalpel (UHS) cuts and coagulates tissue with high-frequency ultrasound. We describe the results of our use of the UHS to perform tonsillectomies in 59 patients. The mean operative blood loss was 7 ml (range: 0 to 75); 56% of patients experienced no measurable blood loss. The mean length of operating time was 8 minutes and 10 seconds (range: 3:45 to 20:25). Patients were assessed for 2 weeks for postoperative pain on the basis of a 10-point linear analog scale. The mean pain score on postoperative day 1 was 4.7; the score peaked at 6.0 on day 4 and fell to less than 3.0 by day 11. Patients returned to full function in an average of 10.9 days (range: 3 to 15). Three patients experienced secondary hemorrhage, one of whom required surgical intervention. We found the UHS to be a well-designed and easy-to-use instrument. Operating time was short, blood loss was minimal, and the degree of early postoperative pain was low. We believe that our findings are encouraging and that the UHS might well have a place in the surgical armamentarium for tonsillectomy.