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The use of the harmonic scalpel in thyroid surgery. Our experience.

Abstract
The aim of this study was to evaluate the potential advantages of the use of Harmonic Scalpel in thyroidectomies in terms of operative time and complications. Between May 2007 and June 2010 1151 patients were submitted to total thyroidectomy. In 681 thyroidectomies were performed using harmonic scalpel FOCUS (group A), in 470 without it (group B). Mean operative time was 97 minutes in group A and 114 in group B with a mean difference of 17 minutes (14.9%). 554 patients in group A (81.35%) and 345 in group B (73.4%) were discharged in second postoperative day. In group A, hypoparathyroidism was present in 348 patients at discharge (48%), in 23 at 6 months (3.38%) and in 10 at 12 months (2.13%), in group B, in 255 at discharge (54.26%), in 61 at 6 months (12.98%) and in 28 at 12 months (5.96%). The major benefit of Harmonic Scalpel used during thyroidectomy is the reduction in the time of operation. All studies but one to date have reported reductions in operative time, ranging from 6 to 78 minutes with a 10% to 35% savings in operative time and this was confirmed in our study. A reduction of hypoparathyroidism, particularly transitory, and in length of hospital stay was reported in some studies and confirmed in our experience. The use of Harmonic Scalpel in thyroid surgery is safe and effective and is associated with a significant reduction in operative time, postoperative hypocalcaemia and hospital stay, without increasing complications rate.
AuthorsPietro Giorgio Calò, Giuseppe Pisano, Fabio Medas, Alberto Tatti, Massimiliano Tuveri, Angelo Nicolosi
JournalAnnali italiani di chirurgia (Ann Ital Chir) 2012 Jan-Feb Vol. 83 Issue 1 Pg. 7-12 ISSN: 0003-469X [Print] Italy
PMID22352209 (Publication Type: Comparative Study, Journal Article)
Topics
  • Algorithms
  • Feasibility Studies
  • Female
  • Hemostasis, Surgical
  • Humans
  • Hypocalcemia (etiology, prevention & control)
  • Hypoparathyroidism (complications, etiology, prevention & control)
  • Length of Stay
  • Male
  • Retrospective Studies
  • Risk Factors
  • Sound
  • Thyroid Neoplasms (surgery)
  • Thyroidectomy (adverse effects, instrumentation, methods)
  • Time Factors
  • Treatment Outcome

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