New Ultrasonic Dissector Versus Conventional Hemostasis in Thyroid Surgery: A Randomized Prospective Study

Sista, Federico; Schietroma, Mario; Ruscitti, Cristina; Santis, Giuseppe De; Vita, Fabiola De; Carlei, Francesco; Amicucci, Gianfranco

doi:10.1089/lap.2011.0266

Cited by 25 publications

(22 citation statements)

References 27 publications

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“…Dicha tecnología se va imponiendo en la mayoría de las unidades dedicadas al tratamiento de esta patología, haciendo necesaria la aparición de estudios que evalúen la eficacia y eficiencia de la misma (costebeneficio) 6,7 . Así, en lo referente a la hemostasia, el bisturí ultrasónico y el sistema de sellado de vasos bipolar son utilizados en la actualidad por la mayoría de las unidades de cirugía endocrina [8][9][10][11][12][13][14][15] . En nuestra Unidad, comenzamos a utilizar en el año 2007 el bisturí ultrasónico.…”

Section: Discussionunclassified

“…Los datos publicados indican que el uso del bisturí ultrasónico implica un menor tiempo quirúr-gico [8][9][10][11][12][13][14][15] , siendo controvertidos los datos referentes a coste y tasa de complicaciones. Así, mientras algunos grupos hablan de una menor tasa de complicaciones 9,12,15,21 , otros dicen que no hay diferencias significativas 8,10,11,13,14 .…”

Section: Uso De Bisturí Ultrasónicounclassified

“…Así, mientras algunos grupos hablan de una menor tasa de complicaciones 9,12,15,21 , otros dicen que no hay diferencias significativas 8,10,11,13,14 . En nuestro estudio vemos que al comparar los dos primeros grupos de pacientes, observamos un significativo ahorro de tiempo quirúrgico en el segundo grupo a expensas de un aumento del coste por paciente.…”

Section: Uso De Bisturí Ultrasónicounclassified

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Eficacia, Seguridad Y Eficiencia De Las Nuevas Tecnologías en Cirugía Tiroidea

et al. 2014

Rev Chil Cir

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Effectiveness, safety and efficiency of new technologies in thyroid surgeryIntroduction: Surgery of the thyroid gland is the most performed procedure by the endocrine surgeon. In the last years, new techniques have been incorporated in this procedure. Our objective is to analyse the impact of these techniques in our department. Methods: We performed a retrospective and comparative study among three samples of patients submitted for total thyroidectomy. Group I: Sample of 96 patients operated between 2004 and 2007 performing total thyroidectomy. In this period we didn`t use ultrasonic scalpel (US) nor intraoperative neuromonitoring (INM). Group II: Sample of 108 patients operated between 2008 and 2010. In this group we used US for hemostasis. Group III: Sample of 82 patients operated between 2011 and 2012. In this group we used both US and INM. The groups are compared: complications, postoperative stay, surgical time and costs per patient. Results: We analysed the following complications: haemorrhage, postoperative hipocalcemia and recurrent nerve palsy. We didn´t find significant differences among the samples of patients but there were a less percentage of recurrent palsy in the third group (4.9% vs 12.5 and 11.1%). We found significant differences when stay, surgical time and costs were analysed. Conclusion: The use of new techniques in thyroid surgery has supposed an improvement not only in the clinic outcomes but in the surgical time.

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Section: Discussionunclassified

Section: Uso De Bisturí Ultrasónicounclassified

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Eficacia, Seguridad Y Eficiencia De Las Nuevas Tecnologías en Cirugía Tiroidea

et al. 2014

Rev Chil Cir

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“…The Harmonic Scalpel (HS) has found wide application in laparoscopy [1,2,3,4], thoracoscopy [5,6] and other surgical procedures [7,8,9]. As regards colon surgery, the HS is used in both open [10] and video-assisted approaches [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…A new HS handpiece (NHS; FOCUS Long Curved Shears, Ethicon Endo-Surgery Inc., Cincinnati, Ohio, USA), with a tip smaller than 5 mm, has been available since 2009. The NHS can ensure more precise dissection near vital structures and it can be safer for ureters and genital vessels, but clinical randomized studies employing this device are still few [9]. The present prospective randomized study has been designed to evaluate the effectiveness and safety of the NHS compared with conventional hemostasis (CH) in open right colon surgery.…”

Section: Introductionmentioning

confidence: 99%

New Harmonic Scalpel versus Conventional Hemostasis in Right Colon Surgery: A Prospective Randomized Controlled Clinical Trial

Sista¹,

Abruzzese²,

Schietroma³

et al. 2013

Dig Surg

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Background: The Harmonic Scalpel (HS) is a device that uses vibrations to coagulate and cut tissues simultaneously. Its advantages are represented by minimal lateral thermal tissue damage, less smoke formation, no neuromuscular stimulation and no transmission of electricity to the patient. Methods: A total of 211 consecutive patients (113 men, 98 women; mean age 64 years) undergoing hemicolectomy for cancer of the right colon were divided into two groups, namely those in whom the operation was performed using a new HS handpiece (NHS; 108 patients) and those assigned to conventional hemostasis (CH; 103 patients). The two surgical groups were compared regarding patients' age and sex, tumor size, location, histotype and local invasiveness assessed by American Joint Cancer Committee stage, operative time, fluid content in the suction balloon (drainage volume) during the first 1-3 days after surgery, hospital stay and complications. Results: Ultrasonic energy delivered through an HS has been shown to be safe and to produce minimal damage to the surrounding tissues because of its minimal heat production. Electrical devices allow hemostatic control in vessels up to 3 mm in diameter, while HS can coagulate vessels up to 5 mm in diameter; thus, HS allows not only better control of bleeding but also of lymphorrhea. In fact, the amount of fluid collected in the drainage was significantly lower in the NHS group compared to the CH group. Protein depletion influences the patient's regenerative capacity and thus also the occurrence of complications and recovery time. Conclusion: NHS is a useful device in colon surgery; it facilitates surgical maneuvers and reduces operative times and blood and lymphatic losses, allowing satisfactory maintenance of protein storage. This results in a lower incidence of complications and faster recovery by patients.

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Euthyreote Knotenstruma (inklusive Basedow und Rezidivstruma)

Billmann

2017

Evidenzbasierte Viszeralchirurgie Benigner Erkrankungen

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New Ultrasonic Dissector Versus Conventional Hemostasis in Thyroid Surgery: A Randomized Prospective Study

Abstract: This NUD may reduce the rate of complications (transient and definitive hypocalcemia, transient damage of the recurrent laryngeal nerve) and operative time.

Cited by 25 publications

References 27 publications

Eficacia, Seguridad Y Eficiencia De Las Nuevas Tecnologías en Cirugía Tiroidea

Eficacia, Seguridad Y Eficiencia De Las Nuevas Tecnologías en Cirugía Tiroidea

New Harmonic Scalpel versus Conventional Hemostasis in Right Colon Surgery: A Prospective Randomized Controlled Clinical Trial

Euthyreote Knotenstruma (inklusive Basedow und Rezidivstruma)

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