Intra-capsular complete tonsillectomy, a modification of surgical technique to eliminate delayed post-operative bleeding

James Albright, Newton Duncan, Abel M. Smerica, Joseph Edmonds

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Pediatric tonsillectomy is a frequently performed procedure using a variety of surgical techniques. Despite decades of modern surgical experience and advances in tools and techniques, a consensus on which technique is superior for minimizing complications has not been established. In a 2014 study, the authors examined differing surgical techniques and devices to determine if there was a significant difference in the bleed rates based on technique and device [1]. In that study 7024 children were evaluated, of which a total of 1.4% (n = 99) of children experienced a postoperative hemorrhage that required a second surgery. There was no significant difference found between the four different techniques that were evaluated. Although the combined rates of post-operative hemorrhage requiring a second surgery was lower compared to many other published reports, we hypothesized that continued improvement in surgical techniques could eliminate post-operative hemorrhage completely. As follow up to that study, we decided on a collective change in technique, and subsequent analysis of our post-operative results with respect to only one outcome, post-operative hemorrhage requiring a second surgery. With a new standardized technique in place, we retrospectively evaluated one year of surgical outcomes. These procedures were performed using the technique of a modified and complete, intra-capsular Coblator tonsillectomy. Of the 783 tonsillectomies done in 12 months, we found there were 0 patients that had experienced a postoperative hemorrhage requiring a second surgery. Based on our previous study with a rate of 1.4% post-operative hemorrhage we would have expected to have 11 episodes of post-operative hemorrhage requiring a second surgery.

Original languageEnglish (US)
Article number109703
Pages (from-to)109703
JournalInternational Journal of Pediatric Otorhinolaryngology
StatePublished - Jan 2020


  • Post-operative hemorrhage
  • Tonsil
  • Postoperative Complications/prevention & control
  • Humans
  • Adolescent
  • Female
  • Male
  • Retrospective Studies
  • Child
  • Reoperation/statistics & numerical data
  • Postoperative Hemorrhage/etiology
  • Tonsillectomy/adverse effects

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology


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