Safety and Efficacy of the Bipolar Radiofrequency Ablation Device for Hemostasis in Thyroidectomy in Comparison With the Conventional Knot-Tying Technique

Abstract

The conventional method of hemostasis by using knot-tying technique is safe and effective in thyroid surgery but it is time consuming. A new energy devices like ultrasonic scalpel and advanced bipolar electrosurgical cautery have been proven to be safe and effective in shortening the length of thyroid surgery but the high cost of these advanced generators that designed to work only with an expensive disposable hand pieces, make its use difficult to justify in some hospitals. Radiofrequency ablation device is a refined type of electrosurgical cautery that utilizes a wave of electrons at a frequency between 2 and 4MHz to seal and divide the targeted tissue and the ablation property of this device act as an extra vessel sealing effect, it can be used with conventional reusable bipolar electrosurgical cautery hand pieces. The aim is to evaluate the safety and efficacy of a simple bipolar radiofrequency ablation device for hemostasis in thyroidectomy in comparison with the conventional knot-tying technique. This study was conducted in Alshiffa General Hospital following the approval of the local ethical committee. Fifty patients with different thyroid gland pathologies underwent total thyroidectomy in which hemostasis was achieved mainly with bipolar radiofrequency ablation device. The results of this group were compared with results of conventional knot-tying technique by the same surgical team at an earlier period. This study showed that bipolar radiofrequency ablation device significantly reduced; mean operative time, amount of foreign suture material, significant reduction in the mean volume of postoperative drainage, early patient discharge from hospital, and less complications. In conclusion, the use of the bipolar radiofrequency ablation device with conventional reusable bipolar cautery forceps for hemostasis in thyroidectomy is a safe, simple technique and effective in reducing the operative time in comparison with the conventional knot-tying technique.