Abstract Background One of the most frequent pediatric surgical procedures carried out globally is tonsillectomy. Even though tonsillectomy is one of the most popular otorhinolaryngology procedures, none of the routinely utilized techniques are now thought to be the best. Objective To evaluate the differences between surgical dissection, bipolar diathermy, and coblation for tonsillectomy in terms of postoperative discomfort, surgical blood loss, and the frequency of complications. Methods A meta-analysis and systematic review that complies with the guidelines set out by the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. In order to find research that compares the methods of bipolar diathermy, cold dissection, and coblation, guidelines and an electronic search of the literature were carried out. Results According to this study, the least risk of main bleeding was associated with bipolar diathermy tonsillectomy, which was followed by coblation and cold dissection tonsillectomy; however, the differences were not statistically significant. The bipolar diathermy approach had the lowest risk, while the coblation technique had the highest secondary bleeding risk, followed by cold dissection. The difference did not achieve statistical significance. In terms of blood loss and operating time, coblation tonsillectomy was the most effective method; the difference between it and cold dissection was large, while the difference between it and bipolar diathermy was negligible. The majority of research demonstrated that the coblation approach was superior to cold dissection and bipolar diathermy in terms of postoperative pain, but we were unable to pool the data since the studies used various postoperative pain measurements. However, the majority of studies found no significant difference between bipolar diathermy and cold dissection. Conclusion Although the difference did not achieve statistical significance, the bipolar diathermy procedure for tonsillectomy was thought to be the superior technique overall in terms of main and secondary hemorrhage outcomes. When compared to the cold dissection approach, the coblation process for tonsillectomy was shown to be the optimum method for intraoperative blood loss; however, the difference between coblation and bipolar diathermy was not statistically significant. The coblation approach was also thought to be the best in terms of operating time, with a substantial difference when compared directly to cold therapy and a negligible difference when compared to bipolar diathermy. According to a comprehensive evaluation of 21 research studies, most studies comparing coblation with all other techniques reveal that it causes less postoperative discomfort than cold dissection and bipolar diathermy. Additionally, there was no discernible difference in postoperative discomfort across trials that examined cold dissection and bipolar diathermy.
Mostafa et al. (2026) studied this question.