Comparative outcomes of BiZact, Coblation and bipolar electrocautery tonsillectomy in children: a prospective cohort study

Objective This study compared pain, operative outcomes, recovery and haemorrhage among children undergoing extracapsular tonsillectomy using BiZact, Coblation or bipolar electrocautery. Methods This prospective, non-randomised cohort study included 120 children undergoing extracapsular tonsillectomy between December 2024 and September 2025 ( n = 40 per group). Pain was assessed using the Wong–Baker FACES scale on post-operative days 1, 3 and 7. Operative time, return to solid food, length of hospital stay, post-operative haemorrhage and device cost were evaluated. Results Pain scores differed significantly among groups at all time points ( p < 0.001). Coblation had lower pain scores, whereas BiZact had the shortest operative time (18 minutes) and earliest return to solid food (3 days). No significant between-group differences were observed in haemorrhage outcomes. Conclusion The findings suggest that the three techniques may offer distinct benefits in terms of post-operative pain, operative efficiency and recovery, with no single technique demonstrating overall superiority.