Thyroid surgery: comparison between the electrothermal bipolar vessel sealing system, harmonic scalpel, and classic suture ligation

Manouras, Andreas; Markogiannakis, Haridimos; Koutras, Athanasios S.; Antonakis, Pantelis; Drimousis, Panagiotis; Lagoudianakis, Emmanuel; Kekis, Panagiotis; Genetzakis, Michael; Koutsoumanis, Konstantinos; Bramis, Ioannis

doi:10.1016/j.amjsurg.2007.01.037

Cited by 105 publications

(85 citation statements)

References 23 publications

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“…The most frequently reported hemorrhagic complication is related to cleavage of the superior thyroid artery, which can be serious even in cases in which the Harmonic Scalpel was used. 14 No statistically significant differences in terms of complication rates were observed among groups. Hypocalcemia is the most frequently encountered complication of total thyroidectomy, although contradictory results have also been reported.…”

Section: Discussionmentioning

confidence: 77%

Differences in Thyroidectomy Outcomes Based on Surgical Method: A Comparison of LigaSure Precise, Harmonic Focus, and Traditional Methods

Çiftçi

2016

International Surgery

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New surgical devices have been developed to improve haemostatic control and vascular closure in thyroid surgery. Here, we compare the efficacy and clinical outcomes of 3 surgical methods, Harmonic Focus, LigaSure Precise, and the traditional suture-ligation method, in patients undergoing total thyroidectomies. This retrospective study compared total thyroidectomies performed between July 2008 and August 2012. Thyroidectomies were performed in 243 patients using Harmonic Focus (n ¼ 81), LigaSure Precise (n ¼ 81), and traditional suture-ligation (n ¼ 81). No significant differences were observed among groups in terms of patient demographics, thyroid weight, pathological diagnoses, pre-and postoperative calcium levels, postoperative complications, length of hospitalization, and clinical outcomes. The Harmonic Focus approach showed an~15% shortening in operating time relative to the suture-ligation group; no statistically significant differences were detected between the LigaSure and traditional suture-ligation groups. All 3 methods were found to be both safe and effective. Operating time was significantly shorter in the Harmonic Focus group; no differences in terms of postoperative complications were observed among groups.

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Section: Discussionmentioning

confidence: 77%

Differences in Thyroidectomy Outcomes Based on Surgical Method: A Comparison of LigaSure Precise, Harmonic Focus, and Traditional Methods

Çiftçi

2016

International Surgery

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“…Manouras et al found that compared with the classic technique, surgical time was reduced significantly by about 20% when the bipolar vessel sealer or harmonic scalpel was used (93.3±12.5 vs. 74.3±14.2 and 73.8±13.8 min, P = 0.001, and P = 0.001, respectively. 13 The 48 hours drain output in group I was 32ml vs 46 ml in group II, Petrakis et al in their study found intra-operative total blood loss was similar between the two groups, but postoperative drain volume was less in harmonic scalpel group than in other (21±15 mL; p <0.01). 14 The use of drainage after thyroidectomy is still a source of debate, in fact Papavramidis et al in his scientific study has concluded that there is no advantage or disadvantage in the use of drainage after thyroid surgery.…”

Section: Discussionmentioning

confidence: 99%

Prospective randomised study using focus harmonic scalpel versus conventional hemostasis for vessel ligation in open thyroid surgery

2017

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Background: The objective was to compare operative factors, postoperative and surgical complications of open thyroidectomy by using FOCUS harmonic scalpel (HS) versus conventional hemostasis.Methods: A prospective randomised study in which 34 patients with benign/malignant thyroid disease patients underwent open thyroidectomy, patients were randomised into two groups, Group -1(HS) - included 19 patients which FOCUS Harmonic scalpel was used exclusively, Group -2(CH) included 15 patients in which conventional hemostasis was used exclusively. We recorded operative time, postoperative blood loss and drain output, postoperative complications and duration of hospital stay, patients were watched for 48-72 hours following surgery. The results were analysed by using student’s t-test.Results: Mean operative time for hemithyroidectomy was 53.40±9.07 minutes in HS group versus 85.25±17.03 minutes in CH group (p-value -0.004) mean operative in patients who underwent near total thyroidectomy is 67.21±10.36 in HS group v/s 109.60±29.35ml in CH group (p-value 0.001), postoperative drain output in patients who underwent hemithyroidectomy in HS group is 16.00±15.16 v/s 36.25±4.78 ml in CH group (p-value 0.008), postoperative drain output in patients who underwent near total thyroidectomy in HS group is 28.21±16.36ml v/s 45.50±8.95ml in CH group(p-value 0.006),length of hospital stay is 3.28±1.06 days in HS group v/s 4.20±1.39days in CH group,(p-value-0.083), complications like temporary hypocalcemia was present in 1 patient in HS group v/s 3 patients in CH group ,temporary RLN palsy was present in 2 patients in each group, there were no cases of permanent RLN palsy in either group, neither were the cases of permanent hypoparathyroidism in either group.Conclusions: FOCUS Harmonic scalpel will reduce operative time, reduces the incidence of symptomatic hypocalcemia but not temporary hypocalcemia,reduces postoperative drain output, reduces the duration of hospital stay, and shows no significance on incidence of temporary/permanent RLN palsy. FOCUS harmonic scalpel supposed to be more reliable and safe instrument that can be used instead of conventional hemostasis techniques in open thyroidectomy.

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“…Manouras et al [1]found that compared with the classic technique, surgical time was reduced significantly by about 20% when the bipolar vessel sealer or harmonic scalpel was used (93.3±12.5 vs. 74.3±14.2 and 73.8±13.8 min, P = 0.001, and P = 0.001, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Suture ligations, however, are time consuming and carry the risk of knot slipping, whereas clips carry the risk of dislodgment and stitch granuloma. Electro cautery, on the other hand, is an unattractive alternative because it produces remarkable thermal spread to adjacent tissue [1]. Here we present our experience with use of bipolar cautery in thyroid surgery.…”

Section: Introductionmentioning

confidence: 99%

A Study of use of bipolar cautery in thyroidectomy for coagulating vascular pedicles instead of conventional ligation

Govindaraj

Meti

Ravikiran

2015

Int Jour of Biomed Res

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Aim: To present our experience with use of bipolar cautery in thyroid surgery. Methods and materials:The study was done between August2011-August2013. Study included all patients undergoing thyroid surgeries for various benign and malignant conditions of thyroid. This study included all age group and both gender. Vascular pedicles were cauterized using conventional bipolar cautery without knot tying. Postoperative outcomes were analyzed. Results: Out of 108 cases, 41 male (37.96%), 67 female (62.04%) patients. M:F 1:1.6. 50(46.29%) cases were malignant and 58(53.70%) benign. Among carcinoma thyroid 56% are papillary, 30% follicular, 10% anaplastic and 4% medullary.52 (48.14%) cases undergone total thyroidectomy, 34(31.48%) lobectomy, 22(20.37%) total thyroidectomy with functional neck dissection. Mean operating time for lobectomy was 20min; total thyroidectomy 35min, total thyroidectomy with functional neck dissection was 90min. Postoperative complications were observed in 11(10.18%) cases. No case of severe bleeding which required re-exploration. 2 (1.85%) surgical site infections. 2(1.85%) cases of unilateral recurrent laryngeal nerve injuries have occurred. Hypoparathyroidism seen in 4(3.7%) cases; 3 transient, 1 permanent due to infiltration by anaplastic carcinoma. Conclusion: Use of conventional bipolar cautery is safe, effective and time saving in thyroid surgeries.

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Thyroid surgery: comparison between the electrothermal bipolar vessel sealing system, harmonic scalpel, and classic suture ligation

Cited by 105 publications

References 23 publications

Differences in Thyroidectomy Outcomes Based on Surgical Method: A Comparison of LigaSure Precise, Harmonic Focus, and Traditional Methods

Differences in Thyroidectomy Outcomes Based on Surgical Method: A Comparison of LigaSure Precise, Harmonic Focus, and Traditional Methods

Prospective randomised study using focus harmonic scalpel versus conventional hemostasis for vessel ligation in open thyroid surgery

A Study of use of bipolar cautery in thyroidectomy for coagulating vascular pedicles instead of conventional ligation

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