Assessment of Safety of Bipolar Diathermy Regarding Recurrent Laryngeal Nerve (Rln) Damage in Thyroid Surgery

Abstract

Aim: to present our experience regarding the safety of bipolar diathermy in relation to recurrent laryngeal nerve (RLN) damage during thyroidectomy. BACKGROUND: Thyroidectomy is one of the most frequently performed surgical procedures all over the world with an encouragingly low morbidity rate. The advent of new biomedical equipment has increased the precision of this procedure and has further reduced the incidence of complications. Classically thyroidectomy, like other surgical procedures was performed by conventional knife and scissor dissection techniques with excessive use of sutures for control of bleeding.METHODS: This is an observational clinical study. In this study we share our experience regarding 52 patients with thyroid gland enlargement who underwent thyroidectomy with the help of bipolar cautery from February 2015 to February 2017 at Islam Teaching Hospital Sialkot.RESULTS: Our study shows that most of the patients (57.7%) belonged to the age group of 18 to 30 years. There was no patient above 50 years of age. Majority of the patients (84.6%) were female. 53.8% of patients underwent hemithyroidectomy, 38.5% of patients underwent a near total thyroidectomy whereas 7.7% of patients underwent a total thyroidectomy. 48.1% of patients took 30 to 45 minutes for their procedures, 46.2% of patients took 45 to 60 minutes, and 5.8 patients took up to 75 minutes. Of the 52 patients, none developed any vocal cord palsy or weakness immediately after the completion of surgery, seen after extubation at the operating table.CONCLUSION: Cautious use of bipolar cautery in the Beahrs triangle is perfectly safe regarding nerve injury as the current stays confined between the two prongs of the bipolar forceps and because it keeps the operating field clear of blood.