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Updated: Apr 28, 2026
Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
Total thyroidectomy with harmonic scalpel combined to gelatin-thrombin matrix hemostatic agent: is it safe and
Giovanni Docimo1, Salvatore Tolone1, Roberto Ruggiero1
1Department of General Surgery, Second University of Naples, Via Pansini 5, 80131 Naples, Italy.
Introduction:
Hemostasis during thyroidectomy is essential; however, the safest, most efficient and cost-effective way to achieve this is unclear. The aim of this study was to evaluate the outcome of total thyroidectomy (TT) performed with combination of harmonic scalpel (HS) and Floseal.
Methods:
Patients undergone TT were divided into two groups: HS + Floseal and traditional hemostasis groups. The primary endpoint was 24-h drain output and blood-loss requiring reintervention. Secondary endpoints included surgery duration, postsurgical complications and hypocalcemia rates.
Results:
Between September 2012 and January 2014, 165 patients were enrolled (100 to HS + Floseal, 65 to standard hemostasis); 80.5% female; mean age 42.3 years. The 24-h drain output was lower in the HS + Floseal group compared with standard TT. HS + Floseal also had a shorter mean surgery time (p < 0.0001) vs standard TT. No differences in post-surgical complications and in hypocalcemiarates between groups.
Conclusion:
combination of Floseal plus the HS is effective and safe for TT and it provides a complementary hemostatic approach.
