Tonsillectomy using ultrasonic scalpel

1.1 Current evidence on the safety and efficacy of tonsillectomy using ultrasonic scalpel appears adequate to support the use of this technique provided that normal arrangements are in place for consent, audit and clinical governance.

1.2 The use of ultrasonic scalpel for tonsillectomy may result in higher rates of secondary haemorrhage than some other techniques, and clinicians wishing to use ultrasound scalpel should be specifically trained. The British Association of Otorhinolaryngologists – Head and Neck Surgeons has agreed to produce standards for training.

1.3 Surgeons should ensure that patients or their parents/carers understand the risk of haemorrhage after tonsillectomy using ultrasonic scalpel. In addition, use of NICE's information for the public is recommended.

1.4 Surgeons should audit and review rates of haemorrhage following tonsillectomy in their own practices and in the context of the techniques they use. Publication of further information about the influence of different techniques and other factors (such as age) on the incidence of haemorrhage after tonsillectomy would be useful in guiding future practice.