Hemostasis during the course of every operation must be complete. It is a condition of general surgery. Every vessel that bleeds must be fastened; even if it stops bleeding momentarily, there is danger of secondary hemorrhage. This is more important when local anesthesia is used. After the compression by anesthesia the secondary hemorrhage occurs. These concepts prevail also in tonsillectomy.
Many times because of lack of practice in making a knot with the fingers or because of the patient's indocility, less effective methods are applied.
Frequently the compression of the cavity is made with gauze, or procaine is infiltrated, or attrition is made with forceps, which later are removed.
I think that hemostasis can be made as thoroughly as in any other operation with the help of the knotter. It is an original instrument designed to make knots in depth. Its principal use is to fasten vessels in tonsillectomy by
COOPER H. DEPTH KNOTTER. AMA Arch Otolaryngol. 1956;63(3):292–293. doi:10.1001/archotol.1956.03830090064014
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