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Objective: To compare different tonsillectomy techniques in terms of postoperative bleeding incidence and postoperative pain. Methods: An arm‐based network analysis was conducted using a Bayesian hierarchical model. The primary and secondary outcomes were postoperative bleeding incidence and mean postoperative pain score. Results: A total of 6464 patients were included for five different interventions (cold dissection tonsillectomy; extracapsular coblation tonsillectomy; intracapsular coblation tonsillectomy [ICT]; bipolar diathermy tonsillectomy [BDT]; monopolar diathermy tonsillectomy). ICT showed the lowest absolute risk (4.44%) of postoperative bleeding incidence (73.31% chance of ranking first) and the lowest mean postoperative pain score (1.74 ± 0.68) with a 94.0% chance of ranking first, whereas BDT showed both the highest absolute risk of bleeding incidence (10.75%) and the highest mean postoperative pain score (5.67 ± 1.43). Conclusions: ICT seems to offer better postoperative outcomes, in terms of reduced risk of bleeding and reduced pain. Further prospective studies are advised to confirm these findings. Level of Evidence: NA Laryngoscope, 134:1696–1704, 2024 [ABSTRACT FROM AUTHOR]

Introduction It is generally accepted that the ideal method of tonsillectomy should have less operative time, blood loss, post-operative haemorrhage and morbidity.1 Objective: To compare post-operative pain, intra-operative blood loss and duration of surgery between cold dissection and bipolar diathermy dissection method of Tonsillectomy. Materials and Methods This study was a prospective and comparative hospital-based study. It was conducted from January 2021 - June 2022 at the Department of ENT of a tertiary referral hospital, Kolkata. 90 patients were included in this study fulfilling the inclusion and exclusion criteria. Results In bipolar diathermy method, the mean total blood loss (in ml) (mean±s.d.) of patients was 15.0778±4.6011 and in cold steel method it was 33.0000±5.8737. Post-operative pain for cold dissection on day 1, day 3 and day 10 was [4.4889±.6613], [2.0222±.7830] and [.3778±.4903] respectively. Post-operative pain for bipolar diathermy on day 1, day 3 and day 10 was [4.9556±.2084], [2.5778±1.0111] and [1.6222±.7474] respectively. Duration (in minutes) for bipolar diathermy dissection was [15.2889±1.9612] and for cold dissection it was [24.0444±2.3351]. Conclusion The blood loss and duration were less in bipolar diathermy method but post-operative pain was more as compared to cold steel method. Keywords Tonsillectomy, cold steel, bipolar diathermy, post-operative pain.

Introduction and Aims: There is no consensus on the optimal tonsillectomy technique in adult patients. The study aims to identify all studies comparing the outcomes of coblation versus bipolar diathermy in adult patients undergoing tonsillectomy. Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Primary outcomes were hemorrhage and postoperative pain. Secondary outcome measures included return to theatre, analgesia, intraoperative bleeding, diet, tonsillar healing, and operation time. Fixed-effects modeling was used for the analysis. Results: Six studies were identified enrolling a total of 1824 patients. There were no significant differences in terms of reactionary hemorrhage (OR = 1.81, P = .51), delayed hemorrhage (OR = 0.72, P = .20), or postoperative pain (mean difference = -0.15, P = .45); however, there is a general trend favuring coblation. For secondary outcomes, no significant differences noted in terms of intraoperative bleeding, diet, and cases returning to theatre. Analgesia administration was either insignificant or higher in the coblation group. The coblation group had longer operation time and greater healing effect on tonsillar tissue. Conclusions: There were no significant differences in outcomes for coblation and bipolar diathermy for adult tonsillectomy patients in this systematic review and meta-analysis. [ABSTRACT FROM AUTHOR]

Background: Tonsillectomy is one of the most frequent and oldest operations performed by otolaryngologists. Tonsillectomy postsurgical complications are uncommon, with post-tonsillectomy bleeding being one of the most significant complications. Aim of the work: To compare the effects of cold dissection technique and hot bipolar diathermy for tonsillectomy on intraoperative blood loss, surgical time, postsurgical pain, hemorrhage, infection, and wound healing in the same patient.Patients and methods: This randomized prospective trial was performed in the Department of Otorhinolaryngology [Faculty of Medicine, Al-Azhar University] from June 2021 to January 2022. The study enrolled 100 cases who had tonsillectomy with or without adenoidectomy to treat chronic tonsillitis. All of the participants signed their informed consent to take part in the study. Randomly, on one side of the same patient, cold dissection tonsillectomy was performed, while bipolar diathermy was performed on the other. We compared the two techniques regarding intraoperative blood loss, surgical time, postsurgical pain, postsurgical hemorrhage, postsurgical infection, and wound healing.Results: As regard age and sex of the studied group, it was founded that the age group ranged between 3 to 19 years with mean age of 10.22 years. These patients were represented by 62 male [62%] and 38 females [38%] of the total number of patients [100]. According to age group distribution, there have been significant differences [p-value < 0.05] with the most frequent percentage in the 5–10-year group [55%]. Regarding the intraoperative data, bipolar dissection had a high significant low operative time [12.02±1.27 min] and blood loss [10.89±1.58 ml] than cold steel dissection with operative time [22.37±2.12 min] and blood loss [20.41±0.78 ml] with p-value < 0.001.Conclusion: Between two tonsillectomy surgical approaches, the bipolar diathermy dissection approach took much less time and produced significantly less intra-operative blood loss than the cold dissection method

This study was designed to assess the surgical outcomes of two commonly used techniques for turbinate reduction (diode laser and bipolar diathermy) in selected group of patients with chronic nasal obstruction which resulted from inferior turbinate hypertrophy. The current study was conducted on adult patients with a diagnosis of inferior turbinate hypertrophy. 42 patients (21 in each group) with an age range of 21–38 years (mean = 26.0 ± 4.1) were included in this work and were randomly distributed in 2 groups: one group was scheduled for diode laser turbinectomy (DLT) while the other group was managed by bipolar diathermy (BDT). In DLT, the machine was on a continuous mode with intermittent loading, with laser energy level set to 6 W (0.3-s pulse, 0.1-s break). Pre- and postoperative assessments were statistically compared via tests from SPSS 19.0 (IBM, Chicago, Illinois; USA). Percentage of categorical variables were compared using the Chi-square (χ2) test. P < 0.05 was considered significant, P˃0.05 was considered non-significant, and P < 0.001 was considered highly significant. At 6 months postoperatively, in cases of DLT, there was high significant improvement as regards nasal obstruction and headache (χ2 = 64.78 and 39 respectively; P < 0.0001). There was insignificant difference as regards rhinorrhea (χ2 = 5.524; P = 0.137). In comparison to the postoperative data of both groups, significant difference was reported as regards nasal obstruction and headache (P < 0.001) and rhinorrhea (P < 0.05). This study demonstrated that both laser and bipolar cautery are effective in improving nasal obstruction and rhinorrhea. Preservation of the nasal mucociliary function was better in the diode laser group. [ABSTRACT FROM AUTHOR]

Introduction With the rising trends in breast cancer throughout the world, the traditional modus of intraoperative tissue dissection using a scalpel, scissors, or electrocautery needs to be re-evaluated in the wake of newer modalities, such as electrothermal bipolar vessel sealing (EBVS) devices, which may theoretically reduce the postoperative complications and morbidity in these patients. Aim and objective The objective of this study is to compare an EBVS device to electrocautery (diathermy) in modified radical mastectomy (MRM), based on selected intraoperative and postoperative outcomes. Study procedure This was a comparative cross-sectional section study that included 60 patients with operable breast cancer (stages I and II, TNM classification, and post-neoadjuvant stage III disease). Patients were divided into two groups for surgery: one group underwent an MRM using the EBVS device (Group A), while the other group had the procedure performed using conventional electrocautery (Group B), as per the surgeon's choice depending on theatre slot and equipment availability. Intraoperatively, the total operative time, time for raising the flaps, time taken for breast tissue dissection, time for axillary dissection, and blood loss were recorded. Postoperative parameters included total drainage volume, number of days of drainage, seroma formation, and other complications. Patients were followed up for one month after surgery, with early postoperative complications such as wound infection, upper limb lymphedema, seroma, flap necrosis, and nerve injuries being documented. Results The groups were found to be comparable in terms of the age distribution, TNM staging, stage grouping, and nodal status of the patients. The EBVS device group demonstrated statistically significant advantages in total operative time, axillary dissection time, flap raising time, breast tissue dissection time, intraoperative blood loss, total drainage volume, and days of drainage. However, no statistically significant difference was found between the two devices in terms of seroma formation, early postoperative complications, and duration of postoperative stay at the hospital. Conclusion While the use of EBVS in MRM provides a considerable decrement in the total operative duration, duration of the various steps of surgery, intraoperative blood loss, and postoperative volume and duration of drainage, these devices do not offer an evident advantage in terms of the postoperative complications or morbidity., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethical Committee, Government Medical College, Thrissur, Thrissur, India issued approval IEC/GMCTCR/2020/042. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Chirukandath et al.)

Background:. To compare the thunder-beat device with bipolar diathermy in surgical outcome of tonsillectomy. Methods: In this prospective study 75 patients who underwent tonsillectomy on one side using thunder beat device and on the other side using bipolar diathermy, were included . The intra- operative blood loss, operative time, post-operative pain and post-operative haemorrhage were taken for analysis in both the surgical procedures. Results: Among the seventy five patients, the age groups ranged from 19-36 years with mean age 25.36+/-5.54 years. Out of 75 patients, 21 were male and 54 were female.The comparison of operation time and intra-operative blood loss between thunder- beat and bipolar diathermy showed statistically significant differences. The comparison of pain score showed statistically significant result with better pain results in bipolar diathermy whereas the secondary haemorrhage was common in thunder beat device. Conclusion: The thunder-beat use in tonsillectomies is less time consuming with decreased intra-operative blood loss. But, the post- operative pain is more as compared to bipolar diathermy. Though, it is safe and effective in performing tonsillectomy but its cost is the main drawback for its regular use.

Background:. To compare the thunder-beat device with bipolar diathermy in surgical outcome of tonsillectomy. Methods: In this prospective study 75 patients who underwent tonsillectomy on one side using thunder beat device and on the other side using bipolar diathermy, were included. The intraoperative blood loss, operative time, post-operative pain and post-operative haemorrhage were taken for analysis in both the surgical procedures. Results: Among the seventy five patients, the age groups ranged from 19-36 years with mean age 25.36+/-5.54 years. Out of 75 patients, 21 were male and 54 were female. The comparison of operation time and intra-operative blood loss between thunder- beat and bipolar diathermy showed statistically significant differences. The comparison of pain score showed statistically significant result with better pain results in bipolar diathermy whereas the secondary haemorrhage was common in thunder beat device. Conclusion: The thunder-beat use in tonsillectomies is less time consuming with decreased intra-operative blood loss. But, the postoperative pain is more as compared to bipolar diathermy. Though, it is safe and effective in performing tonsillectomy but its cost is the main drawback for its regular use. [ABSTRACT FROM AUTHOR]

Introduction: Tonsillectomy is a common surgical procedure done by otolaryngologists. Tonsillectomy is a relatively simple procedure. The concept of implementing it as a day case operation has become increasingly popular. Material and Methods: This is a cross sectional study done in Alahsa city, eastern province, Saudi Arabia during the period from January 2014 to March 2015,This study reported the postoperative hemorrhage after Bipolar diathermy and Cold dissection surgical techniques to evaluate the incidence of the hemorrhage and to identify the possible risk factors associated with its occurrence. Results: Postoperative bleeding occurred in 45 (3.6%) out of 1232 patients. Post-tonsillectomy hemorrhage according to operation technique was significantly higher among patients who underwent bipolar diathermy than cold dissection technique (p

En Abstract Background There is a lack of consensus as regards the optimal approach to the problem of recurrent pediatric epistaxis. Objective The aim of this study was to evaluate the use of bipolar coagulation diathermy in the management of recurrent pediatric epistaxis. Patients and methods This prospective study was conducted on 75 pediatric patients (6-15 years) with recurrent epistaxis, who were evaluated and treated with bipolar diathermic cautery during a 6-month follow-up period. Results During the follow-up period, 65 (87%) patients had complete absence of epistaxis with significant improvement (P ≤ 0.05), nine (12%) patients had less than 10 attacks of epistaxis, and one patient had more than 10 attacks and was controlled with another trial of bipolar diathermic cautery. Patients with normal coagulation profile had significantly better results compared with patients with coagulation defects. Patients had no complications after the procedure. Conclusion Bipolar coagulation diathermy is an effective and safe procedure in the management of recurrent pediatric epistaxis.

Objective: This study aims to investigate the novel use of a simple and inexpensive bipolar-assisted tonsil reduction (B-TR) technique in pediatric cases with adenotonsillar hyperplasia by evaluating long-term results, possible complications, need for reoperation and incidence of recurrence. Methods: We present our long-term retrospective data from 78 consecutive pediatric cases undergoing B-TR combined with adenoidectomy from April 2013 to January 2017. The tonsillar sizes were recorded using the Brodsky grading scale from I to IV, and the patients only with prominant tonsillar sizes (III and higher) and adenoidal sizes exceeding 50% were included in the study group. The tonsil sizes were noted preoperatively, and during the latest follow-up visit after tonsillotomy (min. 9 months postoperatively). Results: With a mean follow-up period of 18.3 months, the mean tonsillar size preoperatively was 3.47 (±0.50) and mean tonsillar size postoperatively was 1.35 (±0.48). A significant difference (p<0.001) was observed between these two groups, excluding the only case who later had undergone tonsillectomy. Minimal uvular edema was noted in 27 children (34.6%), which did not cause any upper airway obstruction in these patients. Conclusion: We describe herein our B-TR technique in details so that it can be learned relatively quickly and used in pediatric cases with adenotonsillar hyperplasia as a treatment option. [ABSTRACT FROM AUTHOR]

Introduction: Total thyroidectomy is one of the most routinely performed head and neck surgical procedures with extremely low mortality. This procedure has been associated with two major complications such as recurrent laryngeal nerve injury and hypocalcaemia due to parathyroid insufficiency. The use of bipolar electrocautery has not been widely accepted in view of thermal damage to adjacent structures. Aim: To study the outcomes and complications of capsular dissection technique along with use of bipolar electrocautery in total thyroidectomy. Materials and Methods: The study was conducted from May 2013 to May 2016. The study was performed at Department of ENT Otorhinolayngology, DM WIMS Hospital, Wayanad, Kerala, India. This retrospective descriptive study analysed the outcome of 130 patients who underwent total thyroidectomy by capsular dissection technique along with use of bipolar electrocautery for cauterization of vascular pedicles, at our institution over a 3 year period. Results: The incidence of permanent unilateral vocal cord palsy was 1.5% and permanent hypocalcaemia was 2.3%. There was no case of haemorrhage or haematoma in this study. Conclusion: Total thyroidectomy by capsular dissection technique along with the use of bipolar electrocautery has very low incidence of recurrent laryngeal nerve and parathyroid injury, as per our data. Hence, we recommend this technique along with routine use of bipolar electrocautery for total thyroidectomy.

Objective: To compare the postoperative pain following bipolar diathermy scissors tonsillectomy (higher temperature dissection) with harmonic scalpel tonsillectomy (lower temperature dissection). Methods: Sixty patients aged 7-40 years planned for tonsillectomy with no other concurrent surgery were randomised to either bipolar diathermy scissors or harmonic scalpel as surgical technique. Blinded to the surgical technique, the patients recorded their pain scores (VAS, 0-10) at awakening and the worst pain level of the day in the postoperative period. All intake of pain medication was also recorded. Results: No statistically significant differences were found between the two groups regarding postoperative pain levels or consumption of pain medication. Conclusion: Usage of the harmonic scalpel does not render less postoperative pain following tonsillectomy when compared with usage of the bipolar diathermy scissors. [ABSTRACT FROM AUTHOR]

The use of LigaSure™ vessel sealing system in head and neck surgery was reported to be reliable and safe, providing sufficient hemostasis and reducing operating time. The aim of this study was to evaluate efficacy of this technique in patients undergoing selective neck dissections. This study was carried out as a prospective controlled study at an otolaryngology department of a tertiary medical center between July 2013 and July 2015. Twenty-five patients older than 18 years who underwent unilateral selective neck dissection for head and neck cancer were included in the study. In the control group (group 2, 10 patients) only monopolar and bipolar diathermy was used; in the Ligasure group (group 1, 15 patients) Ligasure was used for hemostasis and dissection in addition to the conventional techniques. Cervical lymphadenectomy time, operation time, preoperative hemoglobin levels, preoperative hematocrit levels, postoperative hemoglobin levels, postoperative hematocrit levels, total neck drainage and drain removal time were analyzed and compared between the groups. Median operation time in group 1 and 2 were 95 min (IQR = 35) and 142.5 min (IQR = 63), respectively. Median cervical lymphadenectomy time in group 1 and 2 were 55 min (IQR = 23) and 102.5 min (IQR = 49), respectively. Median operation time and cervical operation time were significantly lower in group 1 ( p < 0.05). In conclusion, LigaSure™ vessel sealing system is a safe, efficacious technique and significantly lowers cervical lymphadenectomy and operation time in selective neck dissections compared to controls. Given the superb hemostatic properties, this technique should be in the surgeon's armamentarium when possible. [ABSTRACT FROM AUTHOR]

Objective: To compare post operative the efficacy of tonsillectomy performed by cold steel dissection and bipolar diathermy method. Study Design: Randomized controlled trial. Place and Duration of Study: ENT department POF Hospital Wah from Jan 2013 to Jan 2015. Material and Methods: All the patients presenting with recurrent acute tonsillitis and fulfilling the criterion were included. Two groups of 40 patients each were constituted randomly irrespective of age and sex. Cold steel dissection tonsillectomy was carried out on group A patients while group B was operated by bipolar diathermy method. Patients were examined on 2nd, 10th and 14th post-operative days by the surgeon who was blind about the procedures on these patients. Patients were evaluated for per operative hemorrhage, post-operative hemorrhage and amount of pain experienced by the patients post operatively. Results: Mean age in group A was 25.5 years while it was 24.5 years in group B. There was no significant difference between the operative times of both groups; it was 15.90 minutes for cold steel tonsillectomy and 12.50 minutes for bipolar diathermy group. There was statistically significant difference between the blood losses in both groups. In cold steel it was 90.20 ml while in bipolar diathermy group it was 20.50 ml. Bipolar diathermy tonsillectomy groups experienced more pain at all post-operative visits. Healing was less in bipolar diathermy group as compared to cold steel tonsillectomy at 14th day. Conclusion: This study shows that the both procedures have advantages and disadvantages. Cold steel dissection tonsillectomy was found superior in healing and less amount of pain while the bipolar diathermy method caused less per operative blood loss and more pain. [ABSTRACT FROM AUTHOR]

Introduction Tonsillectomy is a common surgical procedure done by otolaryngologists. Tonsillectomy is a relatively simple procedure. The concept of implementing it as a day case operation has become increasingly popular. Material and Methods This is a cross sectional study done in Alahsa city, eastern province, Saudi Arabia during the period from January 2014 to March 2015,This study reported the postoperative hemorrhage after Bipolar diathermy and Cold dissection surgical techniques to evaluate the incidence of the hemorrhage and to identify the possible risk factors associated with its occurrence. Results Postoperative bleeding occurred in 45 (3.6%) out of 1232 patients. Post-tonsillectomy hemorrhage according to operation technique was significantly higher among patients who underwent bipolar diathermy than cold dissection technique ( p < 0.05). Conclusion Bleeding after operation by bipolar diathermy technique was occurring more frequently within the first five days. Hemoglobin level was significantly decreased in post-tonsillectomy hemorrhage. [ABSTRACT FROM AUTHOR]

Objective: To compare post operative pain and hemorrhage in children after tonsillectomy with bipolar diathermy versus tonsillectomy with cold steel dissection and silk ligation to secure hemostasis. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital (CMH) Kharian from June 2012 to June 2013. Materias and Methods: A total of 126 patients were included in the study through non-probability convenience sampling and randomly divided in two groups of 63 each. In group A patients were treated by tonsillectomy with bipolar diathermy and in group B patients underwent tonsillectomy with cold steel dissection and silk ligation to secure hemostasis. Results in terms of postoperative hemorrhage and pain based on Facial Pain Scale were observed. Results: A total of 126 patients were included in the study and randomly divided in two groups of 63 each. Average age in group A was 6.60 years (SD ± 2.46) and in group B it was 6.31 years (SD ± 2.48). There were 33 males (52.38%) in group A while 37 males (58.73%) in group B. Both the groups are comparable with respect to gender (p=0.473) and age (p=0.522). In group A, there were 5 (7.93%) cases of mild pain as compared to 15 (23.80%) in group B. Similarly there were 32 (50.79%) cases of moderate pain in group A and 39 (61.90%) in group B. In group A 25 (39.68%) had severe pain as compared to 9 (14.28%) in group B. It indicates that patients who underwent tonsillectomy with bipolar diathermy had significantly high frequency of severe pain than group A (p=0.03). In both groups there was no incidence of primary hemorrhage. In group A, 3 (4.76%) patients had secondary hemorrhage and in group B, 1 (1.58%) patient had secondary hemorrhage however this was insignificant (p = 0.310). Conclusion: Cold steel tonsillectomy technique with silk ligation to secure hemostasis is a safe method. It has significantly less postoperative pain as compared to bipolar diathermy technique. However there is no significant difference in post operative hemorrhage between the two methods. [ABSTRACT FROM AUTHOR]

Background: A wide variety of intra-abdominal procedures are performed by laparoscopy with reduced morbidity than open procedures. Dissection and hemostasis specially in complex surgeries is a challenge. The methods available are blunt, scissor, diathermy and ultra-sonic dissections whilst bipolar diathermy can be used to assist hemostasis. Aim: An evaluation was done of the efficacy of ultra-sonic dissector for tissue dissection in comparison with scissor and monopolar diathermy. Material and methods: An analysis was done on the usage of ultra-sonic dissector comparative to scissor and monopolar diathermy. The time of dissection and blood loss were evaluated. The procedures performed were oesophagectomy, Hellers cardomyotomy, Nissen fundoplication, splenectomy, cholecystectomy, distal pancreatectomy, laparoscopy assisted pancreaticoduodenectomy, adrenalectomy, right hemicolectomy, anterior resection and abdomino-perineal resection. Observation: Hundred and ninety five patients underwent cholecystectomy and preferred technique of dissection was monopolar diathermy hook assisted with Merrylands dissector. In hundred and fourteen patients who underwent complex abdominal surgeries dissection on planes which are vascular ultrasonic dissector with bipolar assistance was quicker than bipolar and scissor, whilst providing good hemostasis. Conclusion: Using ultra-sonic dissector with bipolar assist was preferred to use of ultra-sonic dissector alone. The hybrid approach provides better hemostasis whilst reducing the usage time of ultra-sonic dissector allowing longer usage of probes. On less vascular planes monopolar diathermy is adequate. Selective use of ultrasonic dissector will reduce cost of surgery. [ABSTRACT FROM AUTHOR]

Introduction: Total thyroidectomy is one of the most routinely performed head and neck surgical procedures with extremely low mortality. This procedure has been associated with two major complications such as recurrent laryngeal nerve injury and hypocalcaemia due to parathyroid insufficiency. The use of bipolar electrocautery has not been widely accepted in view of thermal damage to adjacent structures. Aim: To study the outcomes and complications of capsular dissection technique along with use of bipolar electrocautery in total thyroidectomy. Materials and Methods: The study was conducted from May 2013 to May 2016. The study was performed at Department of ENT Otorhinolayngology, DM WIMS Hospital, Wayanad, Kerala, India. This retrospective descriptive study analysed the outcome of 130 patients who underwent total thyroidectomy by capsular dissection technique along with use of bipolar electrocautery for cauterization of vascular pedicles, at our institution over a 3 year period. Results: The incidence of permanent unilateral vocal cord palsy was 1.5% and permanent hypocalcaemia was 2.3%. There was no case of haemorrhage or haematoma in this study. Conclusion: Total thyroidectomy by capsular dissection technique along with the use of bipolar electrocautery has very low incidence of recurrent laryngeal nerve and parathyroid injury, as per our data. Hence, we recommend this technique along with routine use of bipolar electrocautery for total thyroidectomy. [ABSTRACT FROM AUTHOR]