Hostname: page-component-5b777bbd6c-gcwzt Total loading time: 0 Render date: 2025-06-22T09:54:01.769Z Has data issue: false hasContentIssue false
  • English
  • Français

Overview of a new tonsillectomy device in adult and paediatric otolaryngology: a systematic and comprehensive review of the literature

Published online by Cambridge University Press:  02 April 2025

Kenny Do Open the ORCID record for Kenny Do [Opens in a new window] ,
Kurtis Young ,
Eric Kawana  and
Jo-Lawrence Bigcas
Kenny Do*
Affiliation:
Department of Otolaryngology – Head & Neck Surgery, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV, USA
Kurtis Young
Affiliation:
Department of Otolaryngology – Head & Neck Surgery, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV, USA
Eric Kawana
Affiliation:
Department of Otolaryngology – Head & Neck Surgery, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV, USA
Jo-Lawrence Bigcas
Affiliation:
Department of Otolaryngology – Head & Neck Surgery, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV, USA
*
Corresponding author: Kenny Do; Email: dok3@unlv.nevada.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

The BiZact device offers precise and versatile functionality for tonsillectomies. The objective of this study is to assess the efficacy and safety of the BiZact instrument for tonsillectomies.

Methods

The researchers used the PRISMA guidelines to retrieve relevant articles from PubMed, Embase and Web of Science. Eight articles were aggregated and examined for this systematic review.

Results

The BiZact device shortens operative time when compared to cold dissection and bipolar electrocautery, where no difference was found when compared to coblation. Intra-operative bleeding was decreased with BiZact tonsillectomy compared to cold dissection and electrocautery, although bleeding was slightly increased when compared to coblation.

Conclusion

The BiZact instrument is an alternative tonsillectomy device that may shorten surgical time as well as reduce intra-operative blood loss. More studies are needed to conduct a meta-analysis directly comparing surgical outcomes of the BiZact device to other techniques.

Keywords

TonsillectomyPalatine TonsilAdenoidsAdenoidectomyDeglutition DisordersElectrocoagulationElectrosurgeryRadiofrequency Ablation
Type
Review Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 10
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Bohr, C, Shermetaro, C. Tonsillectomy and Adenoidectomy. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing, 2024. http://www.ncbi.nlm.nih.gov/books/NBK536942/Google Scholar
Han, CJ, Bergman, M, Harley, RJ, Harley, EH. The pediatric indications for tonsillectomy and adenotonsillectomy: Race/ethnicity, age, and gender. Laryngoscope Investig Otolaryngol 2023;8:577–83Google Scholar
Šumilo, D, Nichols, L, Ryan, R, Marshall, T. Incidence of indications for tonsillectomy and frequency of evidence-based surgery: a 12-year retrospective cohort study of primary care electronic records. Br J Gen Pract 2019;69:e33–41Google Scholar
Randall, DA. Current indications for tonsillectomy and adenoidectomy. J Am Board Fam Med 2020;33:1025–30Google Scholar
MR, Mofatteh, Salehi, F, Hosseini, M, Hassanzadeh-Taheri, M, Meghdadi, S, Hassanzadeh-Taheri, M. Postoperative outcomes in cold dissection versus bipolar electrocautery tonsillectomy: a randomized double-blind controlled study. Indian J Otolaryngol Head Neck Surg 2019;71:182Google Scholar
Karimi, E, Safaee, A, Bastaninejad, S, Dabiran, S, Masoumi, E, Moravej Salehi, F. A comparison between cold dissection tonsillectomy and harmonic scalpel tonsillectomy. Iran J Otorhinolaryngol 2017;29:313–7Google Scholar
Alexiou VG, Salazar-Salvia MS, Jervis, PN, Falagas, ME. Modern technology-assisted vs conventional tonsillectomy: a meta-analysis of randomized controlled trials. Arch Otolaryngol Head Neck Surg 2011;137:558–70Google Scholar
Pynnonen, M, Brinkmeier, JV, Thorne, MC, Chong, LY, Burton, MJ. Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev 2017;(8):CD004619Google Scholar
Falz, H, von Lücken, HJ, Münscher, A, Möckelmann, N. A comparative study of BiZactTM tonsillectomy versus cold steel dissection technique in adults: analysis of operating time, intraoperative blood loss, postoperative bleeding rate and pain. Clin Otolaryngol 2024;49: 299–305Google Scholar
KW, Kwon, Kim, JY, Kwon, JH. BiZact-assisted endoscopic resection of a sinonasal tumor. J Craniofac Surg 2024;35:1272–5.Google Scholar
Tierney, J, Harrison, E, Hodge, JC, Carney, AS Coblation versus BiZact extra-capsular tonsillectomy in adults: a randomized control trial. ANZ J Surg 2024;94:861–6Google Scholar
Chuang, F, Jones, R, Quail, G, Whitfield, B, Ahluwalia, S. Rates of post-tonsillectomy haemorrhage between BiZact™ and bipolar tonsillectomy—a retrospective study. Aust J Otolaryngol 2024;7:5Google Scholar
Krishnan, G, Stepan, L, Du, C, Padhye, V, Bassiouni, A, Dharmawardana, N, et al. Tonsillectomy using the BiZact: a pilot study in 186 children and adults. Clin Otolaryngol 2019; 44:392–6Google Scholar
Ni, G, McAuliffe, D, HK, Sethi, Patel, P, Terk, A. A single center retrospective comparison of post-tonsillectomy hemorrhage between BiZact and Coblator. Int J Pediatr Otorhinolaryngol 2022;158:111165Google Scholar
Baigrie, D, FN, Qafiti, Buicko, Lopez JL. Electrosurgery. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing, 2024. http://www.ncbi.nlm.nih.gov/books/NBK482380/Google Scholar
Metcalfe, C, Muzaffar, J, Daultrey, C, Coulson, C. Coblation tonsillectomy: a systematic review and descriptive analysis. Eur Arch Otorhinolaryngol 2017;274:2637–47Google Scholar
Page, MJ, McKenzie, JE, Bossuyt, PM, Boutron, I, Hoffmann, TC, Mulrow, CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71Google Scholar
NHLBI NIH. Study Quality Assessment Tools [Internet]. National Heart, Lung, and Blood Institute, 2021. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-toolsGoogle Scholar
Manhein, D, Raeder, J. Comparison of Bizact™ low temperature dissecting device with bipolar diathermic scissors for tonsillectomy in adult patients. Austin J Surg 2023;10:1300Google Scholar
Mao, B, Woods, CM, Athanasiadis, T, MacFarlane, P, Boase, S, Joshi, H, et al. BiZactTM tonsillectomy: predictive factors for post-tonsillectomy haemorrhage from a 1717 case series. Clin Otolaryngol 2023;48:672–9Google Scholar
Besser, G, Grasl, S, Meyer, EL, Schnoell, J, Bartosik, TJ, Brkic, FF, et al. A novel electrosurgical divider: performance in a self-controlled tonsillectomy study. Eur Arch Otorhinolaryngol 2022; 279:2109–15Google Scholar
Dharmawardana, N, Chandran, D, Elias, A, Kao, SST, Ooi, EH. Management of post tonsillectomy secondary haemorrhage: Flinders experience. Aust J Otolaryngol 2018;1:31Google Scholar
Cheng, H, Chen, BPH, Soleas, IM, Ferko, NC, Cameron, CG, Hinoul, P. Prolonged operative duration increases risk of surgical site infections: a systematic review. Surg Infect (Larchmt) 2017;18:722–35Google Scholar
Chen, MM, Roman, SA, Sosa, JA, Judson, BL. Safety of adult tonsillectomy: a population- level analysis of 5968 patients. JAMA Otolaryngol Head Neck Surg 2014;140:197–202Google Scholar
Nunez, DA, Provan, J, Crawford, M. Postoperative tonsillectomy pain in pediatric patients: electrocautery (hot) vs cold dissection and snare tonsillectomy–a randomized trial. Arch Otolaryngol Head Neck Surg 2000;126:837–41Google Scholar
Wienerroither, V, Hammer, R, Kornprat, P, Schrem, H, Wagner, D, Mischinger, HJ, et al. Use of LigaSure vessel sealing system versus conventional axillary dissection in breast cancer patients : a retrospective comparative study. BMC Surg 2022;22:436Google Scholar
Brenner, MJ, Shenson, JA, Rose, AS, Valdez, TA, Takashima, M, Ahmed, OG, et al. New medical device and therapeutic approvals in otolaryngology: state of the art review 2020. OTO Open 2021;5:2473974X211057035Google Scholar
Li, Y, Guo, Y, Yang, L, Ni, J. Comparison of the short-term outcomes after low-temperature plasma radiofrequency ablation (coblation) in the Gasserian ganglion for the treatment of idiopathic trigeminal neuralgia. J Pain Res 2019;12:1235–42Google Scholar
Duna Medical Center. Nose and throat tonsil removal gently. In https://dunamedicalcenter.org/en/news/nose-and-throat-tonsil-removal-gently. [03 July 2023]Google Scholar
Lee, YC, Hsin, LJ, Lin, WN, Fang, TJ, Tsai, YT, Luo, CM. Adolescents and adults undergoing temperature-controlled surgical instruments vs electrocautery in tonsillectomy: a systematic review and meta-analysis of randomized clinical trials. JAMA Otolaryngol Head Neck Surg 2020;146:339–46Google Scholar
Haefeli, M, Elfering, A. Pain assessment. Eur Spine J 2006;15(Suppl 1):S17–24Google Scholar
Medtronic. BiZactTM tonsillectomy device. In: https://www.medtronic.com/covidien/en-us/products/vessel-sealing/bizact-tonsillectomy-device.html. [2017]Google Scholar
Xu, B, Jin, HY, Wu, K, Chen, C, Li, L, Zhang, Y, et al. Primary and secondary postoperative hemorrhage in pediatric tonsillectomy. World J Clin Cases 2021;9:1543–53Google Scholar
Ikoma, R, Sakane, S, Niwa, K, Kanetaka, S, Kawano, T, Oridate, N. Risk factors for post-tonsillectomy hemorrhage. Auris Nasus Larynx 2014;41:376–9Google Scholar
Sarny, S, Ossimitz, G, Habermann, W, Stammberger, H. Hemorrhage following tonsil surgery: a multicenter prospective study. Laryngoscope 2011;121:2553–60Google Scholar
Stepan, L, Huang, L, Huynh, J, Xie, P, CM, Woods, Ooi, EH. Health related quality of life T-14 outcomes for pediatric Bizact tonsillectomy. Medicina (Kaunas) 2021;57:480Google Scholar
Childers, CP, Maggard-Gibbons, M. Understanding costs of care in the operating room. JAMA Surg 2018 153:e176233Google Scholar
Saul, B, Ketelaar, E, Yaish, A, Wagner, M, Comrie, R, Brannan, GD, et al. Assessing root causes of first case on-time start (FCOTS) delay in the orthopedic department at a busy level II community teaching hospital. Spartan Med Res J 2022;7:36719Google Scholar
Mizumoto, R, Cristaudo, AT, Hendahewa, R. A surgeon-led model to improve operating theatre change-over time and overall efficiency: a randomised controlled trial. Int J Surg 2016;30:83–9Google Scholar
Kang, B, Liu, XY, Li, ZW, Yuan, C, Zhang, B, Wei, ZQ, et al. The effect of the intraoperative blood loss and intraoperative blood transfusion on the short-term outcomes and prognosis of colorectal cancer: a propensity score matching analysis. Front Surg 2022;9:837545Google Scholar
Rajagopalan, V, Chouhan, RS, Pandia, MP, Lamsal, R, Rath, GP. Effect of intraoperative blood loss on perioperative complications and neurological outcome in adult patients undergoing elective brain tumor surgery. J Neurosci Rural Pract 2019;10:631–40Google Scholar
Walner, DL, Miller, SP, Villines, D, Bussell, GS. Coblation tonsillectomy in children: incidence of bleeding. Laryngoscope 2012;122:2330–6Google Scholar
Leader, BA, Wiebracht, ND, Meinzen-Derr, J, Ishman, SL. The impact of resident involvement on tonsillectomy outcomes and surgical time. Laryngoscope 2020;130:2481–6Google Scholar