LigaSure vs Clamp-and-Tie Technique to Achieve Hemostasis in Total Thyroidectomy for Benign Multinodular Goiter

Marc, Olivier Saint; Cogliandolo, Andrea; Piquard, Arnaud; Famà, Fausto; Pidoto, Rocco Roberto

doi:10.1001/archsurg.142.2.150

Cited by 78 publications

(33 citation statements)

References 32 publications

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“…However, the publications are inconsistent on the issue. Saint Marc and colleagues have reported that the cost of a single procedure with the use of LVSS increased by EUR 45 as compared with classical haemostatic techniques (16). An increase in the costs of thyroid surgery with the use of LVSS has also been noted by Cipolla and colleagues (14).…”

Section: Discussionmentioning

confidence: 91%

“…the limitation to 1.5-2 cm of the range of heat action on surrounding tissues. However, not all publications report a drop in the number of complications: Saint Marc and colleagues have demonstrated a total percentage of complications at 35% (including transient complications) and no statistically significant difference between the group undergoing surgery with the use of LVSS and the one with a classical technique (16).…”

Section: Discussionmentioning

confidence: 99%

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Usefulness of Electrosurgical Techniques in Thyroid Gland Surgery

Kowalski¹,

Bierca²,

Zmora³

et al. 2012

Polish Journal of Surgery

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Wide propagation of new generation of electrosurgical devices such as bipolar vessel sealing systems (eg. Thermostapler® by EMED) enabled seamless closing of blood vessels with a diameter up to 7 mm while maintaining the necessary safety margin, as well as reducing the duration of the operation. We decided to verify these reports in our material. Aim of the study was comparison of thyroid surgery performed with the electrocautery tool -Thermostapler® by EMED with surgery using classic hemostasis technique to evaluate the operative time and complications in the form of bleeding, recurrent laryngeal nerve paralysis, symptoms of hypoparathyroidism, and wound infection. Material and methods. We retrospectively analyzed 256 patients operated in the Department of General and Proctological Surgery Solec Hospital in Warsaw due to inert thyroid goitre. All patients underwent total thyroidectomy. Patients were divided into two groups. The first group consisted of 126 patients operated in 2000, using classic techniques of hemostasis. While the second group consisted of 130 patients operated in 2007-2008 with Thermostapler®. We compared duration of surgery and the incidence of postoperative complications. Results. The operative time was significantly shorter (average 18 minutes) in the second group of patients. We also recorded a statistically significant decrease in the incidence of complications in the group operated with Thermostapler. conclusions. Use of bipolar vessel sealing system in a decisive manner shortens the duration of operation. Use of bipolar vessel sealing system also enables a radical reduction in the incidence of complications rate such as bleeding, recurrent laryngeal nerve paralysis, symptoms of hypoparathyroidism, and wound infection. In the future, similar studies should be performed to assess the real costs resulting from the use Thermostapler®.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Usefulness of Electrosurgical Techniques in Thyroid Gland Surgery

Kowalski¹,

Bierca²,

Zmora³

et al. 2012

Polish Journal of Surgery

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“…Saint Marc et al in his prospective study of 200 patients found that 1 patient in the LigaSure group ( n = 100) and 2 patients in the clamp-and-tie group ( n = 100) required revision surgery due to hematoma. Despite this, the authors considered LigaSure to be as safe as the clamp-and-tie technique [11]. Franko et al obtained similar results.…”

Section: Discussionmentioning

confidence: 99%

Bipolar Thermofusion BiClamp 150 in Thyroidectomy: A Review of 1156 Operations

Pniak

Formánek

Matoušek

et al. 2014

BioMed Research International

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Objectives. To compare the bipolar thermofusion BiClamp 150 with conventional ligature techniques for thyroid gland surgery, and report the advantages/disadvantages of both techniques. Methods. In this retrospective comparative study, all thyroid gland operations performed in the ENT Clinic Faculty Hospital Ostrava from 2006 to 2013 were included (1156 operations, 2122 lobes). Patients were categorized into two groups according to the type of vessel sealing method used, group I (BiClamp, n = 819 operations) and group II (conventional ligature, n = 337 operations). The number of revision surgeries due to wound hematoma was recorded as a bleeding event. Statistical analysis of the complication rate (bleeding rate, recurrent nerve palsy) and time of duration was performed. Results. The rate of revision surgery performed due to postoperative wound hematoma was significantly lower in group I (15/819, 1.83%) compared with group II (14/337, 4.15%) (P = 0.022). There was no statistically significant difference in the frequency of recurrent laryngeal nerve palsy between groups I and II (P = 0.36). The average surgery time was significantly shorter in group I (P < 0.001). Conclusion. Bipolar thermofusion BiClamp is an effective vessel sealing method that leads to a significant reduction in postoperative wound bleeding rates and reduces surgical time compared with conventional vessel ligature.

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“…Two other randomized trials with larger patient numbers have been published during the period of patient inclusion of the present study [4,5]. In both trials a total, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…bilateral thyroidectomy, was done, and both studies reported a time saving effect when the LigaSure was used (see Figure 2). Saint Marc et al concluded however that the time saving was clinically hardly relevant: 41 minutes when using the ligasure versus 49 when using conventional suture ligations [5]. Although this absolute gain of approximately seven and a half minute does not appear to be clinically significant, the total operative time has to be taken into account.…”

Section: Discussionmentioning

confidence: 99%

Randomized clinical trial of LigaSure versus conventional suture ligation in thyroid surgery

et al. 2012

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BackgroundIn thyroid surgery vessel division and haemostasis make up an important and time consuming part of the operation. While the presence of the recurrent laryngeal nerve limits the liberal use of diathermia, the many arterial and venous branches to and from the thyroid gland necessitates the use of numerous conventional suture ligatures.This study evaluates the effect of using a vessel sealing system on operation time during thyroid surgery.MethodsA randomized clinical trial was performed between September 2005 and October 2008 in a teaching hospital. Forty patients undergoing total hemithyroidectomy participated in the trial. Twenty were randomized to the intraoperative use of the LigaSure Precise™ vessel sealing system, and twenty to the use of conventional suture ligatures.ResultsThe total median operation time was 10 minutes shorter in the LigaSure group (56 versus 66 minutes, P = 0.001). No significant differences in complications were noticed.ConclusionUsing an electrothermal vessel sealing system during thyroid surgery is time saving.Trial registrationThis trial was registered in the international standard randomized controlled trials number register (ISRCTNR) under number ISRCTNR82389535.

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LigaSure vs Clamp-and-Tie Technique to Achieve Hemostasis in Total Thyroidectomy for Benign Multinodular Goiter

Cited by 78 publications

References 32 publications

Usefulness of Electrosurgical Techniques in Thyroid Gland Surgery

Usefulness of Electrosurgical Techniques in Thyroid Gland Surgery

Bipolar Thermofusion BiClamp 150 in Thyroidectomy: A Review of 1156 Operations

Randomized clinical trial of LigaSure versus conventional suture ligation in thyroid surgery

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