The Use of Harmonic Scalpel in Subtotal Thyroidectomy: Single Centre Experience (original) (raw)

Thyroidectomy using the harmonic scalpel: A pilot study

Operative Techniques in Otolaryngology-Head and Neck Surgery, 2001

The harmonic scalpel has been successfully used in other surgical disciplines and general otolaryngology. We present a pilot study with the harmonic scalpel for 20 successive thyroidectomies. The advantages conferred by this instrument are superior hemostasis allowing for shortened operating time and smaller incisions.

The use of the harmonic scalpel in thyroidectomy: 'beyond the learning curve

Annals of The Royal College of Surgeons of England, 2009

INTRODUCTION Safe and effective haemostasis in surgery is clearly essential, and in the neck where risks of airway compromise are also present any new technology that purports to offer advantages must be rigorously evaluated. We describe our experience with the use of the Harmonic Scalpel [Ethicon UK] in thyroidectomy. PATIENTS AND METHODS A retrospective clinical review of 183 patients undergoing hemi or total thyroidectomies from 12 months prior to using the harmonic scalpel (2003; n = 77) and 12 months 'beyond the learning curve' (2006; n = 106). RESULTS The results demonstrate that, once past the learning curve, the use of the harmonic scalpel during thyroidectomy significantly reduces operative time and postoperative hypocalcaemia, and is as safe as conventional surgery with regard to voice change and bleeding. CONCLUSIONS The harmonic scalpel is as safe as conventional methods of haemostasis and operations using this technique are quicker once the need to have repetitive 'clip, cut and tie' routines is avoided.

Thyroid surgery with the new harmonic scalpel: A prospective randomized study

Surgery, 2011

Background. Despite their safety and effectiveness in thyroid surgery, the previous harmonic scalpel instruments are considered large and cumbersome by several surgeons. An innovative technical improvement of the device has been made available since 2008. The objective of this study was to compare the results of total thyroidectomy using the new harmonic scalpel (FOCUS) with that with the previously available device (HARMONIC ACE). Methods. A prospective randomized study of all total thyroidectomies between February and July 2008 was conducted. Patients (n = 90) were randomized to undergo total thyroidectomy with FOCUS (group A, n = 45) or HARMONIC ACE (group B, n = 45). Results. No significant differences were identified between the 2 groups in terms of demographics, reoperative thyroid surgery, thyroid gland weight and diameter, pathologic diagnosis, preoperative and postoperative serum PTH and calcium levels, postoperative complications, duration of hospital stay, and final outcome. The mean operative time was less in group A than group B (63 ± 7 min vs 76 ± 8 min, P = .009). Conclusion. The new harmonic scalpel is a useful adjunct to the armamentarium of the thyroid surgeon. It is safe, effective, and hand friendly, offering great capabilities for delicate tissue grasping and dissection. Use of this device decreased operative time compared with the previously available instrument. (Surgery

Harmonic Scalpel Versus Conventional Technique in Total Thyroidectomy (Comparative Study)

Al-Azhar Medical Journal

Background: Thyroid gland is a highly vascular organ. So, doing thyroidectomy requires good hemostasis even for the small blood vessels either through conventional tie technique which is time-consuming or through the use of a harmonic scalpel. Objective: To evaluate the real benefits of the Harmonic Scalpel in total thyroidectomies when compared with conventional ligation, in terms of operative time, postoperative drainage, and complications.

The use of harmonic scalpel in open thyroid surgery: is it rewarding?

International Surgery, 2016

Objectives: To evaluate the advantages and effectiveness of the harmonic scalpel (HS) in open thyroid surgery. Background: Haemostasis is the most important factor for successful thyroid surgery. Our aim was to compare the effect of the use of harmonic scalpel versus the conventional haemostasis (CH) methods during open thyroidectomy in the intra-operative and post-operative outcomes. Methods: A retrospective review of all total thyroidectomy operations performed in six years was done. The patients were divided in two groups: The CH group and the HS group according to the method used. Information regarding patient's age, sex, pathological diagnosis, operations details, operations duration, the blood loss, the use of drains and the complications were recorded. Results: Out of 239 operations performed, 143 operations were in the CH group and 96 operations were in the HS group. The average duration of operation was 73minutes in the HS group vs. 97minutes in the CH group, p->0.00...

Ultrasonic harmonic scalpel in total thyroidectomies

Advances in Therapy, 2008

Introduction: Haemostasis is very important in thyroid surgery. In conventional surgery, electrocoagulation and suture ligation are used for haemostasis; newer techniques include vessel clips, ultrasonic instruments and lasers. The aim of this prospective study was to compare the usage of the ultrasonic harmonic scalpel (UHS) with conventional procedures, in total thyroidectomies, for operation time, blood loss, usage of drain, cost, length of hospitalisation and complications. Methods: We examined 104 patients who underwent bilateral total thyroidectomy. They were divided randomly into two groups. Patients in Group I (n=54) underwent operations using conventional techniques (electrocautery and suture ligation) while patients in Group II (n=50) underwent operations using the UHS. Operation time, number of ligatures used, blood loss, intra-operative complications, weight of the specimen, necessity of drain, postoperative seroma, bleeding, infection, transient or permanent hypocalcaemia, permanent recurrent laryngeal nerve palsy and length of hospitalisation were recorded. Results: The operation time was significantly longer in Group I (conventional) (105±16 minutes; mean±standard deviation) than Group II (UHS) (77.9±12.5 minutes; P<0.001). The mean blood loss was less in patients who were operated on with the UHS (25.3±10.2 g) than in patients operated on with conventional methods (59.5±33.9 g; P<0.