Thyroidectomy using the harmonic scalpel: analysis of 105 consecutive cases

Area of Science:

• Surgical Innovation
• Thyroid Surgery Techniques
• Minimally Invasive Procedures

Background:

• Conventional thyroidectomy techniques have established protocols but can be associated with longer operating times and larger incisions.
• The harmonic scalpel, initially developed for laparoscopic surgery, represents a technological advancement in surgical instrumentation.
• Evaluating new tools for thyroidectomy is crucial for improving patient outcomes and surgical efficiency.

Purpose of the Study:

• To assess the technical benefits of performing thyroidectomy with the harmonic scalpel.
• To compare the harmonic scalpel technique against conventional thyroidectomy methods.
• To determine if the harmonic scalpel offers advantages in terms of incision size and operative duration.

Main Methods:

• A prospective study involving 105 patients undergoing thyroidectomy with the harmonic scalpel.
• Comparison with a historical control group of 20 patients who underwent conventional thyroidectomy.
• Analysis of key surgical metrics including incision length and operating time for hemithyroidectomy and total thyroidectomy.

Main Results:

• Thyroidectomy using the harmonic scalpel resulted in an average incision length of 4.5 cm, compared to 5.5 cm for conventional methods.
• Average operating time for hemithyroidectomy was reduced to 50 minutes with the harmonic scalpel, versus 80 minutes conventionally.
• Total thyroidectomy operating time averaged 80 minutes with the harmonic scalpel, compared to 120 minutes with conventional techniques.

Conclusions:

• The harmonic scalpel provides clear advantages in thyroid surgery, including shorter incisions and reduced operative times.
• Negligible bleeding and a low complication rate were observed with the harmonic scalpel technique.
• The harmonic scalpel facilitates safe and efficient control of feeding vessels, particularly beneficial in limited surgical fields.