Evaluation of the Harmonic Scalpel Use in the Surgical Treatment of Thyroid Diseases
There are different methods to reach hemostasis in the operative field. Recently the harmonic scalpel in surgery has been analyzed.The aim of the study was to compare the advantages in terms of operative time of thyroidectomies performed using the harmonic scalpel versus conventional suture ligation technique. Another aim of the study was to evaluate complications in both groups.Material and methods. From January 1, 2005, to December 31, 2006, 43 patients underwent subtotal thyroid resection using the harmonic scalpel for hemostasis (group 1). They were compared with a group of 46 patients who underwent conventional thyroidectomy with hemostasis achieved by following electrocoagulation and ligation (group 2). The study analyzed the duration of the procedure, considering the volume of the operated thyroid gland and extent of the thyroidectomy in both groups.Results. The duration of the thyroidectomies ranged between 30 and 160 minutes. The comparison in the mentioned groups showed that the harmonic scalpel shortened the duration of the procedure. An iterative procedure was applied with the step of 1 ml of the goiter volume, to check if this effect was present in whole volume range of the operated thyroid.Analysis in subgroups demonstrated that only in case of goiter size <50 ml the use of the harmonic scalpel clinically significant shortened the time of operation.Conclusions. The use of the harmonic scalpel shortened the time of thyroidectomy, as only in patients with the smaller goiter volume.
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