Harmonic Focus™ versus "knot tying" during total thyroidectomy: a randomized trial

Area of Science:

• Endocrinology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Total thyroidectomy (TT) is a common surgical procedure.
• Conventional knot tying (KT) is a standard method for hemostasis during TT.
• Newer devices like Harmonic Focus™ (HF) aim to improve surgical efficiency and outcomes.

Purpose of the Study:

• To compare the efficacy and safety of Harmonic Focus™ (HF) versus conventional knot tying (KT) in total thyroidectomy.
• To evaluate operative time, parathyroid function, and post-operative complications between the two methods.

Main Methods:

• Prospective randomized study involving 81 patients undergoing total thyroidectomy.
• Patients were randomly assigned to either the HF group (43 patients) or the KT group (38 patients).
• Parathyroid function assessed by post-operative parathyroid hormone (PTH) and calcium levels; complications monitored.

Main Results:

• Mean operative time was significantly lower in the HF group (100 min) compared to the KT group (119 min).
• No statistically significant differences were observed in transient hypoparathyroidism or symptomatic hypocalcemia between groups.
• No recurrent nerve injuries were reported in either group.

Conclusions:

• Harmonic Focus™ is a safe, reliable, and time-saving alternative to knot tying for total thyroidectomy.
• The HF device does not negatively influence parathyroid function, medical therapy requirements, or nerve injury rates.
• HF offers ergonomic benefits and comparable safety to conventional methods in thyroid surgery.