Randomized controlled trial of harmonic scalpel use during thyroidectomy
Paolo Miccoli1, Piero Berti, Gianlorenzo Dionigi
1Department of Surgery, University of Pisa, Pisa, Italy. p.miccoli@dc.med.unipi.it
Archives of Otolaryngology--Head & Neck Surgery
|October 18, 2006
Summary
The harmonic scalpel (HS) significantly reduced postoperative pain, drainage, and transient hypocalcemia in thyroidectomy patients. Shorter operative times also favored the HS, potentially offsetting its cost.
Area of Science:
- Surgical Innovation
- Endocrine Surgery
- Minimally Invasive Techniques
Background:
- Thyroidectomy is a common surgical procedure.
- Hemostasis is critical during thyroidectomy to minimize complications.
- Evaluating new surgical tools like the harmonic scalpel (HS) is important for improving patient outcomes.
Purpose of the Study:
- To compare the harmonic scalpel (HS) with conventional hemostasis (CH) in thyroidectomy.
- To assess differences in operative factors, postoperative outcomes, and surgical complications.
Main Methods:
- A single-blind, randomized controlled trial was conducted.
- One hundred patients undergoing total thyroidectomy were included.
- Outcomes measured included postoperative pain, drainage volume, hypocalcemia, nerve injury, and operative time.
Main Results:
- The harmonic scalpel (HS) group showed significantly reduced postoperative pain at 24 and 36 hours.
- Drainage volume was significantly lower in the HS group (40.1 mL vs 75.4 mL).
- Transient hypocalcemia was reduced (10% vs 32%), and operative times were shorter (40.0 vs 46.7 minutes) with the HS.
Conclusions:
- The harmonic scalpel (HS) may lead to better outcomes in thyroidectomy.
- Reduced pain, drainage, and hypocalcemia, along with shorter operative times, suggest potential benefits.
- The HS may be a cost-effective alternative to conventional hemostasis (CH) despite initial costs.
