The introduction of coblation tonsillectomy into Australia was associated with a statistically significant learning curve with respect to both primary and secondary hemorrhage rates.

Australian surgeons still use monopolar diathermy as their preferred technique for tonsillectomy. Local anesthetic, dexamethasone, and postoperative antibiotics are used infrequently, and fewer than 1:4 surgeons perform day-case tonsillectomy.

OBJECTIVES: 1. Identify hemorrhage rates following coblation tonsillectomy. 2. Establish if a learning curve exists with the technique with respect to hemorrhage rates. 3. Identify surgeons' perceptions of the technique with respect to pain and bleed rates. METHODS: Following the Australian National Tonsillectomy Audit of 2005, in early 2006 a supplementary data sheet was sent to all surgeons identified as having experience with coblation for some or all of their tonsillectomies. Hemorrhage events were recorded and surgeons were asked about how they learned the technique and about their perceptions with respect to pain and bleeding rates following coblation tonsillectomy. RESULTS: Data were obtained for 1,740 coblation tonsillectomies with a 70% response rate from targeted surgeons. Inital primary hemorrhage rates were 1.3% initially, falling to 0% with experience (pϽ0.001; mean 0.3%). Secondary hemorrhage rates were 3.4% initially, falling to 1.0% with experience (pϽ0.05; mean 2.1%). Only 10% of surgeons attended a formal course or workshop to learn the technique; 65% of surgeons felt the technique was less painful than other methods with only 25% perceiving coblation-produced lower hemorrhage rates. CONCLUSIONS: In Australian practice, the introduction of coblation tonsillectomy occured with a significant learning curve with respect to hemorrhage rates. This can possibly be explained by the low number of surgeons gaining proper experience with the technique prior to performing it on patients. This has implications for the future introduction of new surgical techniques into otolarynology.