[Comparison of conventional technique, Ligasure Precise and Harmonic Focus in total thyroidectomy]

Area of Science:

• Endocrine Surgery
• Surgical Technology
• Thyroid Procedures

Background:

• Total thyroidectomy is a common endocrine surgery.
• Minimally invasive surgical techniques aim to improve patient outcomes and reduce operative time.
• Comparing novel energy devices with traditional methods is crucial for surgical practice.

Purpose of the Study:

• To compare the efficacy and safety of electrothermal bipolar vessel sealing (Ligasure Precise) and harmonic curved shears (Harmonic Focus) against the traditional technique in total thyroidectomy.
• To evaluate operative time, hospital stay, and complication rates including hypocalcemia and recurrent laryngeal nerve paralysis.

Main Methods:

• A randomized controlled trial involving 93 patients undergoing total thyroidectomy.
• Patients were randomly assigned to three groups: Ligasure Precise (L), Harmonic Focus (F), or traditional technique (C).
• Data collected included demographics, preoperative calcium, operative time, hospital stay, gland weight, pathology, postoperative calcium, and nerve paralysis.

Main Results:

• No statistically significant differences were observed in demographics, age, gender, or pathology classification across the three groups.
• Overall hypocalcemia incidence was 38.9%, with a mean hospital stay of 2.3 days, showing no significant group differences.
• Harmonic Focus significantly reduced mean operation time by approximately 15% compared to the traditional technique (p<0.05).

Conclusions:

• Both Ligasure Precise and Harmonic Focus are safe and effective energy devices for total thyroidectomy.
• Harmonic Focus offers a significant advantage by reducing operative time compared to the traditional method.
• Further research may explore long-term outcomes and cost-effectiveness of these energy devices in thyroid surgery.