A Study of use of bipolar cautery in thyroidectomy for coagulating vascular pedicles instead of conventional ligation

Abstract

Aim: To present our experience with use of bipolar cautery in thyroid surgery. Methods and materials:The study was done between August2011-August2013. Study included all patients undergoing thyroid surgeries for various benign and malignant conditions of thyroid. This study included all age group and both gender. Vascular pedicles were cauterized using conventional bipolar cautery without knot tying. Postoperative outcomes were analyzed. Results: Out of 108 cases, 41 male (37.96%), 67 female (62.04%) patients. M:F 1:1.6. 50(46.29%) cases were malignant and 58(53.70%) benign. Among carcinoma thyroid 56% are papillary, 30% follicular, 10% anaplastic and 4% medullary.52 (48.14%) cases undergone total thyroidectomy, 34(31.48%) lobectomy, 22(20.37%) total thyroidectomy with functional neck dissection. Mean operating time for lobectomy was 20min; total thyroidectomy 35min, total thyroidectomy with functional neck dissection was 90min. Postoperative complications were observed in 11(10.18%) cases. No case of severe bleeding which required re-exploration. 2 (1.85%) surgical site infections. 2(1.85%) cases of unilateral recurrent laryngeal nerve injuries have occurred. Hypoparathyroidism seen in 4(3.7%) cases; 3 transient, 1 permanent due to infiltration by anaplastic carcinoma. Conclusion: Use of conventional bipolar cautery is safe, effective and time saving in thyroid surgeries.

Safety and Efficacy of the Bipolar Radiofrequency Ablation Device for Hemostasis in Thyroidectomy in Comparison With the Conventional Knot-Tying Technique

“…In this study; the patient's age, duration of surgery, number of suture ligations that used to seal thyroid blood vessels, duration of hospital stay, the volume of drainage and the time of drain removal were expressed in mean±SD, other patients characteristics like gender and the complications were expressed in frequencies. There were no significant statistical differences in the patient's characteristics of both groups in term of the age, gender and the perioperative diagnosis as shown in table I. to published result 10,11 . This reduction in the operative time may be due to in part to the ablation effect of the radiofrequency current that leading to a rapid and secured sealing of blood vessels without the need for the time consuming excessive suture ligations which are significantly reduced by using bipolar radiofrequency ablation device to (2.18±1.18) vs (18.12±6.11) for conventional knot-tying technique.…”

“…The bipolar radiofrequency ablation device is a refined type of electrosurgical cautery that utilizes an electrical current at a frequency between 2-4 MHz, with this frequency there is minimal tissue resistance to the passage of electrical current in the target tissue leading to agitation and friction movement between tissue ions leading to heat production, the tissue temperatures stay localized within a (60-100°C) leading to the fusion of collagen and elastin in the walls of the vessel with the creation of a permanent sealed zone without carbonization. In addition to that, the ablation property of radiofrequency current act as an extra vessel sealing effect by decreasing the diameter of blood vessel due to shrinkage of the collagen fibers in the vessel wall 9,10 . In this study, we evaluate the safety and efficacy of a simple bipolar radiofrequency ablation device for hemostasis in total thyroidectomy in comparison with the conventional knottying technique.…”