The use of harmonic scalpel versus Conventional thyroid lobectomy operation At Suratthani hospital
Keywords:
lobectomy, harmonic scalpelAbstract
Backgroud : The harmonic scalpel, although more costly, hasgained wide acceptance because it may reduce intraoperative bleeding and operative duration.The significant advantage of this device is the simultaneously coagulating/dissecting functions, and subsequent timing reduction necessary for conventional clamp and tie technique.The aim of this study was to evaluate the efficiency and the safety of Harmonic scalpel when compared to conventional
Clamp and tie in open thyroid lobectomy.
Methods : A retrospective study was conducted using the medical records of patients who underwent conventional thyroid lobectomy with clamp and tie technique (CT) and Harmonic scalpel (HS) thyroid lobectomy at Suratthani hospital during 2012-2014. Outcomes, including surgical time, complication rates, and length of hospital stay, were compared between groups.
Results : The use of Harmonic scalpel was associated to a significant reduction of surgical operative time (76.84 mins in CT vs56.86 mins in HS,p 0.0001). The length of hospital stay in 2 groups was similar (3.46 days in CT group vs 3.21 days in HS group) Also the complication rate was similar between groups( recurrent laryngeal nerve paralysis and post operative hematoma ).
Conclusions : According to our experience, the Harmonic scalpel represents a safe alternative to conventional haemostasis in thyroid surgery, allowing for a significant reduction of operative time. The rate of complication demonstrated no significant difference among the two groups.
References
2. Pezzullo L: Complications of thyroid surgery: analysis of a multicentricstudy on 14,934 patients operated on in Italy over 5 years. World J Surg 2004, 28(3):271–276
3. Laycock WS, Trus TL, Hunter JG: New technology for the division of shortgastric vessels during laparoscopic Nissen fundoplication. A prospectiverandomized
trial. SurgEndosc 1996, 10(1):71–73.
4. Amaral JF: The experimental development of an ultrasonically activatedscalpel for laparoscopic use. SurgLaparoscEndosc 1994, 4(2):92–99.
5. Ferri E, Armato E, Spinato G, Spinato R: Focus harmonic scalpel comparedto conventional hemostasis in open total thyroidectomy: a prospectiverandomized trial. Int J Otolaryngol 2011, 2011:357195.
6. Shemen L Thyroidectomy using the harmonic scalpel: analysis of 105consecutive cases. Otolaryngol Head Neck Surg: Offic J Am AcadOtolaryngolHead Neck Surg.2002; 127(4):284–288
7. Siperstein AE, Berber E, Morkoyun E .The use of the harmonic scalpel vsconventional knot tying for vessel ligation in thyroid surgery. Arch Surg. 2002; 137(2):137–142
8. Cannizzaro . SpringerPlus 2014,3:639http://www. springerplus.com/content/3/1/6399.Duan et al. Journal of Otolaryngology - Head and Neck Surgery 2013,
42:62
9. Duan et al : Focus harmonic scalpel compared to conventional hemortasis in open total thyroidectomya prospective randomized study. Journal of Otolaryngology-
Head and neck Surgery 2013 42:62
10. Adrienne L. Melch,SamM.Wiseman.International Journal of oncology 2010:396079
