Efficacy of harmonic focus scalpel in seroma prevention after axillary clearance

Selvendran, Selwyn; Cheluvappa, Rajkumar; Trương, Vinh Khiêm; Yarrow, S.; Pang, Tony; Segara, Davendra; Soon, Patsy

doi:10.1016/j.ijsu.2016.04.041

Cited by 9 publications

(8 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, this study demonstrated that the rate of postoperative seroma was comparable between the Harmonic scalpel and monopolar electrocautery. In concordance with our findings, Archana et al [ 15 ] and Selvendran et al [ 18 ] reported no significant difference between the Harmonic scalpel and monopolar electrocautery regarding the incidence of post-BC surgery seroma. Similar findings were reported by others [ 19 , 20 ].…”

Section: Discussionsupporting

confidence: 93%

Intraoperative and postoperative outcomes of Harmonic Focus versus monopolar electrocautery after neoadjuvant chemotherapy in breast conservative surgery: a comparative study

et al. 2021

View full text Add to dashboard Cite

Background Surgical devices are commonly used during breast conservative surgery (BCS) to provide better hemostasis. The Harmonic scalpel has recently gained momentum as an effective tool for intraoperative bleeding reduction. This comparative study was designed to determine the efficacy of Harmonic Focus in reducing postoperative complications of BCS after neoadjuvant chemotherapy (CTH) compared to the conventional method using monopolar diathermy. Results A prospective, nonrandomized, comparative study was conducted on patients scheduled to undergo BCS with axillary dissection after neoadjuvant CTH. Patients in the Harmonic Focus group had significantly shorter operative times than the monopolar electrocautery group (101.32 ± 27.3 vs. 139.3 ± 31.9 min, respectively; p < 0.001). Besides, blood loss was significantly lower in the Harmonic Focus group (117.14 ± 35.6 vs. 187 ± 49.8 mL, respectively; p < 0.001). Postoperatively, patients in the Harmonic Focus group had a significantly lower volume of chest wall drain (p < 0.001) and shorter time until drain removal (p < 0.001). Likewise, patients in the Harmonic Focus group had a significantly lower volume of axillary drain and shorter time until drain removal than monopolar electrocautery (p < 0.001). The incidence of postoperative complications was comparable between both groups (p = 0.128). Conclusions This study confirmed the superiority of Harmonic Focus compared to monopolar electrocautery among patients receiving neoadjuvant CTH before BCS.

show abstract

Section: Discussionsupporting

confidence: 93%

Intraoperative and postoperative outcomes of Harmonic Focus versus monopolar electrocautery after neoadjuvant chemotherapy in breast conservative surgery: a comparative study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…However, in the present study, we demonstrated that the rate of postoperative seroma was comparable between Ultrasonic shear and monopolar electrocautery. In concordance with our ndings, Archana et al (25), and Selvendran et al (27), reported no signi cant difference between Ultrasonic shear and monopolar electrocautery regarding the incidence of post-BC surgery seroma. Similar ndings were reported by other studies(28,29).…”

Section: Discussionsupporting

confidence: 92%

Ultrasonic Shear Device versus Monopolar Electric Cautery in Conservative Breast Surgery Following Neoadjuvant Chemotherapy: A Comparative Study

Khaled¹,

Saad²,

Soliman³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Surgical devices are commonly used during breast-conservative surgery (BCS) to provide better hemostasis. Ultrasonic shear has recently gained momentum as an effective tool for intraoperative bleeding reduction. This comparative study was designed to determine the efficacy of Harmonic focus in reducing postoperative complications of BCS following neoadjuvant chemotherapy (CTH), in comparison to the conventional method using monopolar diathermy.Methods: We conducted a prospective, non-randomized, comparative, study on patients scheduled to undergo BCS with axillary dissection or sentinel lymph node biopsy after neoadjuvant CTH. Patients were recruited consecutively throughout the study period and were divided in an equal manner to undergo either monopolar electrocautery or Harmonic focus®.Results: Patients in the Harmonic Focus group had significantly shorter operative time than the monopolar electrocautery group (101.32 ± 27.3 versus 139.3 ± 31.9 minutes, respectively; p <0.001). Besides, the blood loss was significantly lower in the Harmonic Focus group (117.14 ± 35.6 versus 187 ± 49.8mL, respectively; p <0.001). Postoperatively, patients in the Harmonic Focus group had a significantly lower volume of chest wall drain (p <0.001) and shorter rime till drain removal (p <0.001). Likewise, patients in the Harmonic Focus group had a significantly lower volume of axillary drain and shorter rime till drain removal than monopolar electrocautery (p <0.001). The incidence of postoperative complications was comparable between both groups (p =0.128). Conclusions: In conclusion, the current study confirms the superiority of Harmonic Focus, compared to monopolar electrocautery, amongst patients receiving neoadjuvant CTH before BCS.

show abstract

“…On the other hand, Militello et al [14], Selvendran et al [57] and Manjunath et al [58] showed how the application of HS did not reduce the incidence of seroma after breast surgery. Furthermore, despite the alternative results, various studies underline the high costs for the usage of HS [52,57,58].…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, subsequent studies, reported significant reduction in seroma formation [ 51 – 53 ], reduced intra-operative time [ 54 ], reduced intra-operative blood loss [ 55 ] and reduction in drainage output [ 56 ]. On the other hand, Militello et al [ 14 ], Selvendran et al [ 57 ] and Manjunath et al [ 58 ] showed how the application of HS did not reduce the incidence of seroma after breast surgery. Furthermore, despite the alternative results, various studies underline the high costs for the usage of HS [ 52 , 57 , 58 ].…”

Section: Discussionmentioning

confidence: 99%

Advanced hemostasis in axillary lymph node dissection for locally advanced breast cancer: new technology devices compared in the prevention of seroma formation

et al. 2019

View full text Add to dashboard Cite

Background: Breast cancer is the most frequent neoplasm in women. Axillary lymph nodes dissection represents the treatment of choice in locally advanced breast cancer for prognostic and curative purposes. Seroma formation, an abnormal collection of fluid in the dead space of the axilla, is described in Literature with a wide range of incidence (3-85%). It is a source of significant morbidity and discomfort. The aim of the study is to compare the different haemostasis devices used in breast surgery, investigating the eventual superiority of an instrument among the others in terms of intraoperative and postoperative outcome, especially of seroma formation. Methods: Clinical cases of female patients undergone axillary lymph nodes dissection for local advanced breast cancer between January 2013 and July 2017 at the Surgery Unit of University of Campania "Luigi Vanvitelli" were retrospectively reviewed. Patients were divided into four groups, according to device utilized during surgery: Electrocautery, Harmonic Scalpel, LigaSure and Thunderbeat. All patients underwent II level axillary lymph nodes dissection associated to radical mastectomy or quadrantectomy. Results: One hundred consecutives patients were enrolled in the study. Intra-operative blood loss resulted statistically significant different (P < 0,01) between the Electrocautery group (94,7 ml) and the Thunderbeat group (57,2 ml), while the Harmonic Scalpel group and the Ligasure group, despite presented a lower amount of blood loss, did not differ significantly. Drainage volume resulted significantly lower (P = 0,002) in the comparison between the Electrocautery group and the Thunderbeat group; the Ligasure group and Harmonic Scapel group showed no difference between them and Electrocautery group. About the seroma formation, the Electrocautery group resulted affected by the highest seroma formation rate (64%). Seroma incidence in Harmonic Scalpel group was 24%, in Ligasure group was 44%, while Thunderbeat group showed the lowest presentation of seroma with 16%. Conclusions: In patients affected by breast cancer requiring axillary lymphnodes dissection, the use of advanced hemostasis devices is highly desirable. Among the non-traditional tools, Thunderbeat resulted to be superior in terms of reduction of intra-operative blood loss and post-operative drainage output, moreover associated to a substantial reduction of postoperative seroma incidence.

show abstract

Efficacy of harmonic focus scalpel in seroma prevention after axillary clearance

Cited by 9 publications

References 17 publications

Intraoperative and postoperative outcomes of Harmonic Focus versus monopolar electrocautery after neoadjuvant chemotherapy in breast conservative surgery: a comparative study

Intraoperative and postoperative outcomes of Harmonic Focus versus monopolar electrocautery after neoadjuvant chemotherapy in breast conservative surgery: a comparative study

Ultrasonic Shear Device versus Monopolar Electric Cautery in Conservative Breast Surgery Following Neoadjuvant Chemotherapy: A Comparative Study

Advanced hemostasis in axillary lymph node dissection for locally advanced breast cancer: new technology devices compared in the prevention of seroma formation

Contact Info

Product

Resources

About