Comparison of surgical outcomes and complications between the Harmonic FOCUS and conventional surgery for open thyroidectomy

Abstract

Abstract. The aim of the present study was to evaluate the potential advantages of the ultrasonic scalpel compared with the conventional technique in thyroid surgery. Patients with resectable thyroid cancer and Basedow's disease were assigned to ultrasonic scalpel or conventional technique (knot-tying and electrocoagulation). The present study used the Harmonic FOCUS ® (HF) as an ultrasonic scalpel. Between February 2013 and May 2016, 45 patients were enrolled into the study. Duration of the surgery was significantly decreased in the HF group compared with the conventional surgery (CS) group (median 142 vs. 151 min; P=0.0406). Intraoperative blood loss and total volume of drainage fluid were significantly decreased in the HF group compared with the CS group (median 40 vs. 125 ml; P=0.0054, and median 120 vs. 175.5 ml; P=0.0490). Duration of drain placement and length of hospitalization stay were similar in the two groups. Furthermore, the overall incidence of postoperative complications did not differ between the two groups. Overall, the present study suggests that open thyroidectomy using the HF is safe and effective and not associated with any increase in complications.

Impact of body mass index on short-term outcomes after differentiated thyroid cancer surgery: a nationwide inpatient database study in Japan

“…However, the difference in the post-operative length of stay was less than 1 day. Furthermore, whereas the post-operative length of stay in the present study is comparable with that of previous studies reported from Japan (37,38,39), it is considerably longer than that of previous studies from other countries. This is presumably because the length of stay in Japan is generally long, being approximately three times that in Western countries (40), this difference reportedly being attributable to differences in health care systems (41).…”

The Use of Harmonic Focus and Thunderbeat Open Fine Jaw in Thyroid Surgery: Experience of a High-Volume Center

“…As regards operative times, shorter operations obtained using the energy-based devices rather than the traditional technique, as widely described in the literature [ 14 , 15 , 16 , 18 , 19 , 21 , 23 ], make it possible to increase the number of operations in the same surgical session, thus optimizing the utilization of the operating theatres and reducing the waiting lists. Furthermore, shorter operative times reduce anaesthesia times, allowing for faster recoveries after surgery, and decrease anaesthesia costs of each individual procedure.…”

“…In the literature, several reports comparing the energy-based devices with the traditional technique exist. In most of these studies, Harmonic Focus and LigaSure Small Jaw (a device that works by means of advanced bipolar energy) [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ] were evaluated. Far fewer studies that compare the different devices with each other exist [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ].…”

Technological Innovations in Thyroid Cancer Surgery

“…While some studies found no difference in complication rates when comparing EBDs vs. conventional clamp and tie techniques [33,35], others highlighted a reduction in postoperative transient hypocalcemia, postoperative cervical hematoma, and definitive recurrent laryngeal nerve palsies compared to standard hemostasis [36,37]. Similar results regarding postoperative hemorrhage were found comparing LS vs. the conventional clamp and tie technique, as highlighted by Grøndal et al [38], while other authors did not find any difference regarding postoperative cervical hematoma or RLN injury rates when EBD was compared to the standard technique [11,39,40].…”

“…The use of HF is extensively studied in the literature, and all studies agree that it significantly reduces operative times compared to standard clamp and tie techniques [32][33][34][35][36].…”