[The use of harmonic scalpel in head and neck surgery: a report on 161 patients]

The harmonic scalpel cuts and coagulates simultaneously using a mechanical vibration. The present article reports our experience in the use of this instrument. Over a period of 5 months, we performed 123 thyroidectomies, 13 parotidectomies and 25 tonsillectomies using the harmonic scalpel. 106 thyroidectomies, 9 parotidectomies and 30 tonsillectomies were performed with the use of conventional hemostatic techniques (electrocautery and knot tying). The use of harmonic scalpel shortened the duration of thyroid and parotid surgery by 20-30% as compared with the conventional techniques. The average incision length for those undergoing thyroidectomy with the harmonic scalpel was 1.5 cm shorter compared with the conventional thyroidectomy group. The use of harmonic scalpel shortened the average duration of tonsillectomy by 5.5 minutes. Postoperative pain and complication rate were comparable for both groups. The use of the harmonic scalpel reduces surgical time and intraoperative blood loss, and enables shorter incision length in thyroid surgery.