Abstract
BackgroundThe essential objectives for thyroidectomy are: avoidance of injury to the recurrent laryngeal nerves, conservation of the parathyroid glands, an accurate haemostasis and an excellent cosmesis. In the last 10 years major improvements and new technologies have been proposed and applied in thyroid surgery; among these mini-invasive thyroidectomy, regional anaesthesia and intraoperative neuromonitoring, and new devices for achieving dissection and haemostasis. Minor bleeding from small vessels could be a major complication in thyroid surgery. The purpose of ligating vessels is to maintain the surgical site free from an excess of blood and reduce blood loss in the patient.Materials and methodsHydroxylated polyvinyl acetal tampons (HPA) are made by a synthetic, open cell foam structure able to absorb fluids up to 25 times the initial weight. We tested their efficacy for small bleeding control and tissue dissection during several thyroid procedures.ResultsHPA tampons have been found extremely useful to absorb blood coming from minor and diffuse loss, helping to control bleeding by a combined action of fluid absorption and local compression. The porous design of the tampon allows the use of the suction device right through the tampon itself. Thanks to the initial mildly hard consistency, we also used HPA tampons as dissecting instruments.ConclusionIn our experience the use of HPA tampons resulted extremely efficient for minor bleeding control, fluids removal and tissue dissection during thyroid surgery.
Highlights
The essential objectives for thyroidectomy are: avoidance of injury to the recurrent laryngeal nerves, conservation of the parathyroid glands, an accurate haemostasis and an excellent cosmesis
In our experience the use of Hydroxylated polyvinyl acetal tampons (HPA) tampons resulted extremely efficient for minor bleeding control, fluids removal and tissue dissection during thyroid surgery
In a previous laboratory test we found than 1 cm2 of HPA tampon was able to absorb a significantly greater amount of blood than the same surface of standard surgical swab; it has been found that HPA tampons were able to absorb fluids up to 25 time their initial weight [4]
Summary
The essential objectives for thyroidectomy are: avoidance of injury to the recurrent laryngeal nerves, conservation of the parathyroid glands, an accurate haemostasis and an excellent cosmesis. In the last 10 years major improvements and new technologies have been proposed and applied in thyroid surgery; among these mini-invasive thyroidectomy, regional anaesthesia and intraoperative neuromonitoring, and new devices for achieving dissection and haemostasis. Minor bleeding from small vessels could be a major complication in thyroid surgery. New technologies have been proposed and applied in thyroid surgery, such as the mini-invasive video-assisted thyroidectomy (MIVAT) and the intraoperative monitoring of recurrent laryngeal nerve (RLN) [1,2]. In general the essential objectives for thyroidectomy are: conservation of the parathyroid glands, avoidance of injury to RNL, an accurate hemostasis and an excellent cosmesis.
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