Risk of Complications with Energy‐Based Surgical Devices in Thyroid Surgery: A National Multicenter Register Study

Carlander, Johan; Wagner, Philippe; Gimm, Oliver; Nordenström, Erik; Jansson, Svante; Bergkvist, Leif; Johansson, K.-A.

doi:10.1007/s00268-015-3270-7

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…TB is considered advantageous due to its ability to gain a rapid surge in temperature with minimal thermal spreading. Recently, Ligasure TM Exact was introduced adding a new instrument in the arsenal of endocrine surgeon (6)(7)(8). This instrument works in the same fashion that Ligasure Small Jaw works, but has a special anatomic design that makes it easier to work in tight spaces, by maximizing the line of sight.…”

Section: Original Articlementioning

confidence: 99%

“…• Cervicomediastinal goiters [7] • Total thyroidectomy with central lymph node dissection [18] • Total thyroidectomy with lateral lymph node dissection [15] • Thyroidectomy combined with parathyroidectomy [13] • Transoral thyroidectomy vestibular approach (TOETVA) [4] • Neck reoperation [7] Figure 1 Flow diagram of the study.…”

Section: Patients Assessed For Eligibility N=247mentioning

confidence: 99%

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Comparing LigasureTM Exact dissector with other energy devices in total thyroidectomy: a pilot study

Papavramidis¹,

Pliakos²,

Chorti³

et al. 2020

Gland Surg

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Background: Hemostasis is fundamental in thyroid surgery. The aim of this randomized active comparator-controlled study was to compare the effectiveness of Ligasure TM Exact to previously existing sealing devices in patients undergoing thyroidectomy.Methods: A total of 180 patients were randomly allocated into 4 groups according to the hemostatic device used: Focus Harmonic Scalpel ® (FHS), Ligasure TM Small Jaw (LSJ), Thunderbeat ® (TB), and Ligasure TM Exact (LE). We recorded epidemiologic and biochemical data, operative difficulty, postoperative vocal alteration and pain, complications, operating time, grams of gland excised per minute, and hospitalization.Results: Differences (P<0.001) were observed concerning duration of surgery, operative difficulty and quantity of gland removed per minute. Concerning duration of surgery it is shorter for LE followed by TB and then by both FHS and LSJ. Concerning the quantity of thyroid removed per minute LE leads, followed by FHS and TB. The least amount of gland removed per minute is by LSJ. Finally, operative difficulty was less for LE, while it was equal for all other three devices.Conclusions: Energy devices are now frequently used in thyroidectomy. Comparing these devices seems to qualify them as equal concerning post-operative complications, hemostasis, and acute inflammatory reaction.However, Ligasure TM Exact Dissector seems to have better results concerning duration of surgery, quantity of thyroid tissue removed per minute and intraoperative difficulty.

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Section: Original Articlementioning

confidence: 99%

Section: Patients Assessed For Eligibility N=247mentioning

confidence: 99%

Comparing LigasureTM Exact dissector with other energy devices in total thyroidectomy: a pilot study

Papavramidis¹,

Pliakos²,

Chorti³

et al. 2020

Gland Surg

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“…Many studies has conducted in the past, but almost no one study shows that conventional knot method is better comparative to harmonic but recent studies done with highly advanced technology shows that harmonic scalpel is much better than ligation [12].…”

Section: Discussionmentioning

confidence: 99%

Comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy

2019

JMPB

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Objective: The basic aim of this study is to find out comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy.Methodology: This randomized control trial was conducted in Surgery Department, Bahawal Victoria Hospital Bahawalpur. This study was completed in 5 months (August 2018 to January 2019) and all the patients under trial were asked for informed consent. A total number of 100% (n=62) were taken in this trial and online source Openepi.com was used for calculating sample size. Patients were selected by lottery method. Computer software SPSS version 23.2 was used for complete data entry and analysis. All the descriptive variables like onset of action and age were presented as SD and mean. Statistical test ANOVA was applied to find the significance among all groups. Chi square test was applied for analysis of continuous stats among groups. P value 0.05 was to be considered as significant.Result: A total number of 100% (n=62) patients were included, divided into two equal groups, 31 in each i.e. harmonic scalpel and conventional knot groups. The mean age of the patients, in harmonic scalpel group, was 45.29±4.56 years. There were 64.5% (n=20) males and 35.5% (n=11) females. The mean age of the patients, in conventional knot, was 44.96±2.97 years. There were 74.2% (n=23) males and 25.8% (n=8) females. No significant difference was found for age (t=0.329, p=0.743) and gender (χ 2 =0.683, p=0.409) in groups. The main outcome variables of this study were the time of procedure (minutes) and blood loss volume (ml). The mean time of procedure was 98.80±16.52minutes and 119.81±9.95 minutes for the harmonic scalpel and conventional knot groups respectively. Significant difference was found for the time of procedure in groups (t=-6.060, p-value = 0.000). Conclusion:The whole study can be ended with this conclusion that the harmonic scalpel is more effective than the conventional method of ligation or knotting in thyroidectomy. Its use offer many clinical benefits including reduction in time of surgery and blood volume as well. Introduction:The description about the thyroid gland is very prehistoric' for the first time it was name as "shield shape gland" by the Romans [1] . In the literature during 12 th or 13 th century not only the thyroid masses were mentioned but in 1170 Robert Frugard explained the complication of goiter. Thyroid surgery was begun in 12 th century by using hot iron, Setons and caustics powers (most results were fatal).At that time, the major advancement was, antisepsis, artery forceps and anesthesia to be practice [2] .The pioneers of thyroid surgery, Theodor Koches and Theodor Billroth, formulated many acceptable techniques of thyroid surgery between the year 1873 and 1883 [3] . In conventional method knot tying and ligation were important process. The very important thing of this operation is that the thyroid gland is one of the highly vascularized among all the organs having rich blood vessels and plexuses present in the parenchyma. This needs to be controlle...

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“…Although the level of evidence for the benefit of IONM is limited to class II and class III studies, it should be recognized that the same level of evidence applies to most of our clinical practice within thyroid surgery and any other technology applied as energy based device utility, intact parathyroid hormone (iPTH), endoscopic or robotic procedures, florescence, etc. (9). From the other surgical procedures using IONM as spinal surgery to that of vascular, brain surgery, even the more accredited analyses (such as Cochrane reviews) fail to demonstrate class I evidence (1,(10)(11)(12).…”

Section: Is It Evidence-based?mentioning

confidence: 99%

The Consistency of Intraoperative Neural Monitoring in Thyroid Surgery

et al. 2018

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Numerous operating tools and technology transfers are available for thyroid surgery teams performing open, endoscopic and robotic procedures but none, or very few, of them constitutes a mandatory prerequisite. Over the past decade, the choice of intraoperative neurophysiological monitoring (IONM) of the recurrent laryngeal nerve (RLN), has been reached certain consensus, which must at least be selected on an individual basis. Identification and intraoperative assessment of the RLN seems to be more effectively performed with IONM than solely visually or endoscopically. Today, IONM has evolved sufficiently to increase the likelihood of successful functional outcomes in many patients. The transition from the concept of intermitted neural monitoring of the RLN to that of continuous functions evaluation that must be appreciate requires highly skilled knowledge of IONM. This goal will be more likely achieved in centers highly specialized in thyroid surgery.

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Risk of Complications with Energy‐Based Surgical Devices in Thyroid Surgery: A National Multicenter Register Study

Cited by 5 publications

References 33 publications

Comparing LigasureTM Exact dissector with other energy devices in total thyroidectomy: a pilot study

Comparing LigasureTM Exact dissector with other energy devices in total thyroidectomy: a pilot study

Comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy

The Consistency of Intraoperative Neural Monitoring in Thyroid Surgery

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