Monobloc Total Thyroidectomy Using Sealing Devices: Preliminary Results and Comparative Analysis

Abstract

Background: Dorinţa unei hemostaze perfecte a determinat industria echipamentelor medicale să producă instrumente "ideale" necesare unei tiroidectomii sigure. Astfel, instrumentele de hemostază-sigilare, cum ar fi LigaSure TM Small Jaw, Thunderbeat TM Open Fine Jaw şi Harmonic TM Focus au fost concepute pentru chirurgia tiroidiană. Scop: Scopul acestui studiu este de a prezenta rezultatele iniţiale ale utilizării acestor trei instrumente chirurgicale pentru efectuarea tiroidectomiei monobloc. Materiale and Metodă: Am efectuat un studiu prospectiv între ianuarie 2014 şi iulie 2019, în care am inclus toţi pacienţii operaţi de acelaşi chirurg folosind aceste 3 dispozitive de sigilare. Tiroidectomiile au fost efectuate folosind LigaSure TM Small Jaw (grupul 1), Thunderbeat TM Open Fine Jaw (grupul 2) şi Harmonic TM Focus (grupul 3). Grupurile au fost comparate statistic din punct de vedere al duratei intervenţiei chirurgicale şi a spitalizării, complicaţiilor postoperatorii timpurii, precum şi alterarea vocii sau apariţia insuficienţei respiratorii acute. Rezultate: Nu s-au observat diferenţe semnificative între grupuri în ceea ce priveşte datele demografice a pacienţilor, diagnosticul patologic preoperator, complicaţiile postoperatorii precoce şi durata spitalizării. Timpul operator a fost mai scurt în grupul 1. Concluzii: Noile instrumente chirurgicale au proprietăţi benefice, AbstractBackground: The desire for perfect haemostasis has led the medical equipment industry to produce "ideal" instruments for safe thyroidectomy. Thus, haemostasis and sealing instruments such as the LigaSure TM Small Jaw, Thunderbeat TM Open Fine Jaw and Harmonic TM Focus have been indicated for thyroid surgery. Aim: The purpose of this study is to present the initial results of using these three surgical instruments for performing monobloc thyroidectomy. Material and Methods: We performed a prospective study between January 2014 and July 2019 in which we included all the patients operated by same surgeon using those 3 sealing devices. Thyroidectomies were performed using LigaSure TM Small Jaw (group 1), the Thunderbeat TM Open Fine Jaw (group 2) and Harmonic TM Focus (group 3). The groups were statistically compared in term of duration of surgery and hospitalisation, early postoperative complications as well as voice alteration or acute respiratory failure. Results: No significant differences were observed among groups in terms of patient demographics, pathological diagnoses, postoperative complications, length of hospitalization, and clinical outcomes. Operating time was shorter in group 1. Conclusions: New surgical instruments have beneficial properties, including shortening the operative time, maintaining a clean operating field, and minimising smoke released during the operation.

The Utility of LigaSure in Breast Surgery

“…We noted that the use of the LigaSure TM Small Jaw device proved more efficient, in that it shortened the operative time, but the operative time was not statistically significantly different between the 2 groups. The utility of LigaSure TM Small Jaw in reducing operative time and controlling haemorrhage has been reported not only in surgery on the thyroid gland [8,9] but also in skin-sparing mastectomy for breast cancer [10]. This aspect has also been demonstrated in a meta-analysis that compared the LigaSure TM Small Jaw device to other methods of haemostasis/lymphostasis and found that the LigaSure TM Small Jaw shortened the operative time and reduced haemorrhage and other complications [11].…”