Ultrasonically activated shears in thyroidectomies: a randomized trial

Area of Science:

• Surgical Technology
• Endocrine Surgery
• Minimally Invasive Surgery

Background:

• Ultrasonically activated shears (UAS) have demonstrated safety and speed in various surgical procedures, primarily in non-randomized studies.
• Previous matched-pair studies suggested advantages of UAS in thyroidectomies.

Purpose of the Study:

• To validate the benefits of ultrasonically activated shears (UAS) in thyroidectomies through a randomized controlled trial.
• To compare the efficacy and safety of UAS versus conventional hemostatic methods in thyroid surgery.

Main Methods:

• A randomized trial comparing ultrasonically activated shears (UAS) with conventional methods for thyroidectomies and lobectomies.
• Patients underwent procedures for benign or malignant thyroid disease, with randomization stratified by surgeon experience and procedure type.
• Key outcome measures included operative time, postoperative serum calcium levels, recurrent laryngeal nerve palsy, and bleeding volume.

Main Results:

• The ultrasonically activated shears (UAS) group demonstrated a mean operating time of 99.1 minutes, compared to 134.9 minutes in the conventional group, yielding an average time saving of 35.8 minutes.
• No significant differences in complications, including postoperative serum calcium levels, recurrent laryngeal nerve palsy, or bleeding, were observed between the UAS and conventional groups.
• Statistical analysis indicated that the observed time savings would be even greater if surgeon experience imbalances were accounted for.

Conclusions:

• Ultrasonically activated shears (UAS) are a safe and effective device for performing total thyroidectomies and lobectomies.
• The study confirms the utility of UAS in endocrine surgery, offering significant reductions in operative time without compromising patient safety.