Thyroidectomy with energy-based devices: surgical outcomes and complications—comparison between Harmonic Focus, LigaSure Small Jaw and Thunderbeat Open Fine Jaw

Abstract

Background: Being the thyroid gland a highly vascularized organ, achieving a meticulous hemostasis is essential to avoid serious complications. Currently, energy-based devices are widely used in thyroid surgery.The aim of this study was to compare Harmonic Focus (HF), LigaSure Small Jaw (LSJ) and Thunderbeat Open Fine Jaw (TB) in terms of surgical outcomes and complications.Methods: Patients undergoing thyroidectomy in our Unit between January 2012 and June 2018 were retrospectively analyzed. According to the type of energy-device used, patients were divided into three groups: Group A (HF), Group B (LSJ) and Group C (TB).Results: A total of 1,165 patients were included in this study: 1,012 in Group A, 96 in Group B and 57 in Group C. Demographic data and histopathological findings were comparable between the three groups. About the postoperative stay and complications, no statistically significant difference was found.The mean operative time was 89.41±20.60 minutes in Group A, 85.57±15.91 minutes in Group B and 78.07±17.67 minutes in Group C (P<0.01). However, the post-hoc test for all pairwise comparisons showed a statistically significant difference only between Group A and Group C.Conclusions: HF, LSJ and TB have proved to be safe and effective. The postoperative stay and complications were comparable between the three groups. Considering the limits of our investigation, further studies are needed to investigate the effect of TB on operative times.

Papillary Thyroid Cancer Prognosis: An Evolving Field

“…Thyroid surgery represents the first line therapeutic approach for DTC patients [ 60 , 61 , 62 ]. Although conventional open thyroidectomy is still the main intervention, over the last decades alternative surgical procedures have been established in order to achieve more pleasing cosmetic results, especially in young women worried about the neck scar [ 60 ].…”

Sutureless Total Thyroidectomy for Substernal Goiter: Amending Versus Unnecessary

“…As such, some authors asserted that utilization of most used energy-based devices: (i) Ultrasonic Harmonic Focus Scalpel (HF), (ii) LSJ, and (iii) Thunderbeat Open Fine Jaw (TB) are effective and even safe in both hemostasis and dissection nearby the course of the inferior laryngeal nerve and even the suspensory Ligament of Berry. LSJ has been declared as utilizing advanced bipolar energy, attains hemostasis via emaciating elastin and collagen bundles in the vessel wall, rearranging them into a permanent plastic-like autologous seal structure that can seal the vessels up to seven mm in diameter [ 18 , 19 ]. In addition, the thyroidectomy with the relevant surgical collar procedure via intermittent or continuous intraoperative neural monitoring, IIONM, CIONM, particularly in the management of these kinds of gland pathologies have been recommended [ 5 , 20 ].…”

Antibiotic Prophylaxis for Thyroid and Parathyroid Surgery: A Systematic Review and Meta‐analysis

“…22 Furthermore, many centers have reported their experience without the routine use of preoperative AP, reporting a low incidence of SSIs. 11,[23][24][25] In addition, it is important to consider that in the last decades, thyroid and parathyroid surgery has undergone several changes, with the introduction of new devices and techniques that allow for reduced skin incision, tissue manipulation, surgical time, bleeding, and use of sutures [25][26][27][28] ; it is likely that these innovations have contributed to a further reduction of SSIs. However, even if no evidence supports the use of AP in thyroid and parathyroid surgery, many surgeons still use it routinely, with an approach that appears to be more dogmatic than evidence based.…”