The Use of a Vessel Sealing System in Thyroid Surgery

Abstract

Thyroidectomy is one of the most common operations performed for thyroid diseases throughout the world and has an extremely low morbidity rate. Although the technique of thyroidectomy has changed little for several years, different techniques have been developed for haemostasis in addition to the conventional methods. The vessel sealing system (Ligasure™) is a new technology that can be applied in several surgical situations. However, there is no data in the literature regarding its use in thyroid surgery.Fifteen consecutive euthyroid patients (ten women, five men) with a range of 37–71 years of age who met the inclusion criteria were studied. The surgical procedures were performed by a single surgeon using standard techniques, but all vascular structures encountered were sealed by Ligasure™ and no suture material was used. The pre-operative, intraoperative and postoperative parameters were recorded and analyzed. Fluid collection was evaluated by ultrasonography and clinical examination on the 3rd postoperative day, The results were compared with the conventional knot tying method in a group of 25 patients.A Ligasure™ device was successfully used in 15 consecutive procedures, including ten total thyroidectomies, three hemithyroidectomies, one subtotal thyroidectomy and one near-total thyroidectomy. There was no operative mortality or technique-related morbidity in patients. The operating time was 75 ± 11 minutes. The mean volume of the resected thyroid specimens was 68.3 ± 18.9 cm3. The mean fluid collection at postoperative day three was 7.5 ± 1.6 cm3.In conclusion, we have found that a Ligasure™ device can be safely used for haemostasis in thyroid surgery. It has the potential to decrease the operating time, fluid collection and blood loss.