The Use of Harmonic Scalpel in Open Thyroid Surgery: Is It Rewarding?

Abstract

The advantages and effectiveness of the harmonic scalpel (HS) in open thyroid surgery were evaluated. Haemostasis is the most important factor for successful thyroid surgery. Our aim was to compare the effect of the use of harmonic scalpel versus the conventional haemostasis (CH) methods during open thyroidectomy in the intra-operative and postoperative outcomes. A retrospective review of all total thyroidectomy operations performed in six years was done. The patients were divided in two groups: the CH group and the HS group according to the method used. Information regarding patient's age and sex, pathological diagnosis, operations details, operations duration, the blood loss, the use of drains, and the complications were recorded. Out of 239 operations performed, 143 operations were in the CH group and 96 operations were in the HS group. The average duration of operation was 73 minutes in the HS group versus 97 minutes in the CH group (P < 0.005). Blood loss was less in the HS group (P = 0.014), with fewer drains (P < 0.005). Transient hypocalcaemia (TH) was less in the HS group (12.5% vs. 25.9%, P = 0.012). The hospital stay was less in the HS group (3.4 days vs. 3.9 days, P = 0.001). The use of HS was more costly. HS use in thyroid surgery reduces: operation time, blood loss, use of drains, postoperative TH, and shortens hospital stay. It is more costly but the advantages of its use in a busy hospital offset this drawback.