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Total thyroidectomy with ultrasonic scalpel: a multicenter, randomized controlled trial.

Luiz P Kowalski1, Alvaro Sanabria, José Guilherme Vartanian

  • 1Department of Head and Neck Surgery and Otorhinolaryngology, Hospital AC Camargo, São Paulo, Brazil. lp_kowalski@uol.com.br

Head & Neck
|February 4, 2012
PubMed
Summary

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The ultrasonic scalpel offers a safe alternative for total thyroidectomy, significantly reducing operative time and postoperative drainage compared to conventional methods. Costs were comparable between the two surgical techniques.

Area of Science:

  • Endocrine Surgery
  • Surgical Technology

Background:

  • The ultrasonic scalpel is an emerging device in head and neck surgical procedures.
  • Total thyroidectomy represents the most frequently performed endocrine surgery.

Purpose of the Study:

  • To compare the safety and efficacy of the ultrasonic scalpel versus conventional techniques for total thyroidectomy.
  • To evaluate operative time, complication rates, drainage, pain, and costs.

Main Methods:

  • An open-label, phase IV, multicenter, randomized controlled trial (RCT) was conducted.
  • 261 patients undergoing total thyroidectomy were enrolled across 11 centers.
  • Outcomes measured included surgical complications, operative duration, drainage volume, postoperative pain, and associated costs.

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Main Results:

  • The ultrasonic scalpel group demonstrated a 17% reduction in operative time.
  • No statistically significant differences in postoperative complication rates were observed between the groups.
  • While the ultrasonic scalpel group showed a 14% cost difference, it was not statistically significant.

Conclusions:

  • The ultrasonic scalpel is a safe alternative to conventional techniques for total thyroidectomy.
  • Its use is associated with shorter operative times and reduced postoperative drainage.
  • There was no significant difference in costs between the ultrasonic scalpel and conventional methods.