LigaSure versus conventional hemostasis in thyroid surgery: prospective randomized controlled trial.

Area of Science:

• Surgical Innovation
• Thyroid Surgery Techniques
• Minimally Invasive Procedures

Background:

• Hemostasis is crucial in thyroid surgery, often prolonging operative time.
• The LigaSure (LS) system offers diathermy hemostasis by fusing vessel walls.
• Prior research suggested LS reduces thyroidectomy operative times.

Purpose of the Study:

• To compare operative times of the LS system versus conventional clips and ties (CLTs) in thyroidectomy.
• To evaluate secondary outcomes including vocal cord function, Voice Handicap Index (VHI) scores, hypocalcemia, and costs.

Main Methods:

• Twenty-eight patients undergoing thyroidectomy were randomized to either the LS system or CLTs.
• Data collected included patient demographics, operative times, VHI scores, vocal cord endoscopy, and operative costs.
• Postoperative monitoring for hypocalcemia was performed.

Main Results:

• Mean operative times were similar: 68.6 minutes (CLTs) vs. 68.5 minutes (LS), P > .05.
• Postoperative VHI scores were significantly lower with LS (6.57) compared to CLTs (19.83), P = .041.
• The LS system incurred significantly higher operative costs ($387.15) than CLTs ($73.60), P < .001.

Conclusions:

• The LigaSure system did not offer a clinically significant reduction in operative time for thyroidectomy.
• Despite improving voice handicap scores, the LS system's significantly higher cost limits its utility.
• Findings contradict previous literature suggesting reduced operative times with the LS system.