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Prospective, case–control study of surgical efficiency of ultrasonic shear (‘harmonic scalpel’) thyroidectomy compared with conventional thyroidectomy

Published online by Cambridge University Press:  19 February 2008

S K Kang*
Affiliation:
Department of Otolaryngology/Head & Neck Surgery, Southern General Hospital, Glasgow, UK
T Kunanandam
Affiliation:
Department of Otolaryngology/Head & Neck Surgery, Southern General Hospital, Glasgow, UK
L Clark
Affiliation:
Department of Otolaryngology/Head & Neck Surgery, Southern General Hospital, Glasgow, UK
*
Address for correspondence: Dr S K Kang, Department of Otolaryngology/Head & Neck Surgery, Southern General Hospital, 1345 Govan Rd, Glasgow G51 4TF, UK. E-mail: skkang@ntlworld.com

Abstract

Objectives and hypothesis:

To evaluate the efficacy of ultrasonic shear (‘harmonic scalpel’) thyroidectomy, compared with conventional thyroidectomy.

Study design:

Prospective, case–control comparison.

Methods:

Twenty-three consecutive patients were recruited over an eight-month period. Patients were divided into two groups according to their thyroidectomy technique, i.e. ultrasonic shear technique (harmonic scalpel) vs conventional technique (scalpel and bipolar diathermy). Surgical time, thyroidectomy type and thyroid specimen weight were recorded by theatre nursing staff. The ratio of surgical time to specimen weight, in minutes per gram, was used to measure surgical efficiency. The unpaired Student's t-test was used for statistical analysis.

Results:

The mean surgical time per specimen unit weight was 2.56 min/g for harmonic scalpel thyroidectomy and 5.99 min/g for conventional thyroidectomy. This difference was statistically significant (p = 0.037). The difference was most evident for procedures involving smaller thyroid glands.

Conclusions:

Our study suggests that thyroidectomy using a harmonic scalpel is more time-efficient than conventional thyroidectomy, especially when operating on smaller thyroid glands.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 Tebala, GD. Three-port laparoscopic cholecystectomy by harmonic dissection without cystic duct and artery clipping. Am J Surg 2006;191:718–20CrossRefGoogle ScholarPubMed
2 Underwood, RA, Dunnegan, DL, Soper, NJ. Prospective, randomized trial of bipolar electrosurgery vs ultrasonic coagulation for division of short gastric vessels during laparoscopic Nissen fundoplication. Surg Endosc 1999;13:763–8CrossRefGoogle ScholarPubMed
3 Nezhat, F, Mahdavi, A, Nagarsheth, NP. Total laparoscopic radical hysterectomy and pelvic lymphadenectomy using harmonic shears. J Minim Invasive Gynecol 2006;13:20–5CrossRefGoogle ScholarPubMed
4 Wrightson, WR, Edwards, MJ, McMasters, KM. The role of the ultrasonically activated shears and vascular cutting stapler in hepatic resection. Am Surg 2000;66:1037–40CrossRefGoogle ScholarPubMed
5 Siperstein, AE, Berber, E, Morkoyun, E. The use of the harmonic scalpel vs conventional knot tying for vessel ligation in thyroid surgery. Arch Surg 2002;137:137–42CrossRefGoogle ScholarPubMed
6 Cordon, C, Fajardo, R, Ramirez, J, Herrera, MF. A randomized, prospective, parallel group study comparing the harmonic scalpel to electrocautery in thyroidectomy. Surgery 2005;137:337–41CrossRefGoogle Scholar
7 Shemen, L. Thyroidectomy using the harmonic scalpel: analysis of 105 consecutive cases. Otolaryngol Head Neck Surg 2002;127:284–8CrossRefGoogle ScholarPubMed