[Hemostasis and bleeding control in thyroid surgery using electrothermal system (Ligasure): our experience in 317
Dror Ashkenazi1, Salim Mazzawi, Yoseph Rakover
1E.N.T. Department Ha'Emek Medical Center, Afula, Israel. dror_as@clalit.org.il
Background:
Intraoperative bleeding during thyroidectomy can cause hemodynamic shock and even death. Efforts to control bleeding may prolong the operation and put at risk adjacent organs. Postoperative bleeding sometimes requires reoperation, and may prolong the hospitalization and the recovery period. There are different ways of achieving hemostasis-ligations, sutures, clips and coagulation methods. Ligasure is an electrothermal sealer, which seals vessels using physical pressure and electric bipolar coagulation. The device has been used in thyroid surgery in recent years.
Aim:
To describe the advantages and disadvantages in the use of Ligasure in the light of our experience and in the literature.
Methods:
(1) Retrospective review of 317 patients who underwent thyroidectomy, using Ligasure, in the period 2002-2005. (2) Summary of research results in which Ligasure was used.
Results:
In the 317 operations there were no bleeding events nor was there any thermal damage to the recurrent laryngeal nerve. The use of Ligasure did not extend the operative duration or the rate of complications of recurrent laryngeal nerve palsy or hypo-parathyroidism.
Conclusion:
The use of Ligasure is effective in the prevention of operative bleeding in thyroid surgery, and it does not prolong the operative time nor raise the rate of complications. In comparison with other sealing methods we found Ligasure to be the most effective. The main disadvantage of Ligasure is its cost. We recommend the use of Ligasure in thyroid surgery.