Comparison of Total Thyroidectomy with Ligasure Small Jaw Device and Harmonic Scalpel

Abstract

Objective: To compare our experience with the LigaSure small jaw device and Harmonic scalpel in total thyroidectomy regarding operative time and major complications associated with surgery.
 Study Design: Prospective comparative study.
 Place and Study Duration: General Surgery Department, Pak Emirates Military Hospital, Rawalpindi and Combined Military Hospital, Kohat Pakistan, from Oct 2017 to Apr 2020.
 Methodology: This study included 150 patients diagnosed with simple/toxic multinodular goitre, thyroid carcinoma, and diffuse thyroid enlargement. Eighty-one patients were randomly assigned to the LigaSure Group and 69 to the Harmonic Group who underwent total thyroidectomy. Mean operative time and major complications like blood loss, hematoma, hypocalcemia, recurrent laryngeal injury, and surgical site infection were compared.
 Results: Median (IQR) operative time of the LigaSure small jaw device was 55.00(11) minutes, and that of the Harmonic scalpel was 60.00 (11) (p<0.001). The postoperative hematoma formation in the LigaSure small jaw device was 1(1.2%), and that in the Harmonic scalpel Group was 0(0%) (p=0.35). There was no bilateral nerve injury in both Group. The percentage of hypocalcemia (second postoperative day to seventh postoperative day) in the LigaSure small jaw device was 2(2.5%), and that in the Harmonic scalpel Group was 2(2.9%) (p=0.9). 
 Conclusion: The mean operative time of Thyroid surgery with a LigaSure small jaw device is less than that with a Harmonic scalpel. There is no difference in intraoperative blood loss and postoperative complications between them.