The use of the harmonic scalpel for the control of thyroid vessels during thyroid surgery is safe, and it shortens the operative time by almost 30 minutes compared with the conventional technique for both unilateral lobectomy or total thyroidectomy procedures.Tzu-Yen Huang 1,2, Yi-Chu Lin 1, Hsin-Yi Tseng 1, Gianlorenzo Dionigi 3, Hoon-Yub Kim 4, I-Cheng Lu 5,6, Pi-Ying Chang 6, Feng-Yu Chiang 7,8, Che-Wei Wu 1,5,9ġDepartment of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan 2Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan 3Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University Hospital G. There was no effect of tumor size on operative time (Pearson correlation factors: 0.14 for total, 0.21 for unilateral thyroidectomy). There was no difference between the 2 techniques regarding the amount of blood loss for different procedures.

Mean +/- SD operative time was shorter in the harmonic scalpel group compared with the conventional technique group for both lobectomy (89 +/- 20 minutes vs 115 +/- 25 minutes P<.01) and total thyroidectomy (132 +/- 39 minutes vs 161 +/- 42 minutes P<.01) procedures.

Mean +/- SD thyroid size tended to be larger in the harmonic scalpel group for both lobectomy (5.1 +/- 2.6 cm vs 4.2 +/- 2.2 cm P =.06) and total thyroidectomy specimens (6.3 +/- 3.8 cm vs 4.8 +/- 2.9 cm P =.08) compared with the conventional technique. There were no intraoperative complications. The 2 groups were similar regarding age and sex. One hundred seventy-one consecutive patients undergoing lobectomy or total thyroidectomy by one surgeon (A.E.S.).Įighty-six patients underwent thyroid surgery with the conventional clamp-and-tie technique (lobectomy, n = 49 total thyroidectomy, n = 36) and 85 with the harmonic scalpel (lobectomy, n = 38 total thyroidectomy, n = 47).ĭemographics, pathological characteristics, thyroid size, operative time, blood loss, and complications using a 2-tailed t test, chi(2)test, and Wilcoxon rank sum test. We hypothesized that the use of the harmonic scalpel could lead to a significant reduction in operative time as compared with knot tying in thyroid surgery. The harmonic scalpel, using ultrasonic frictional heating to ligate vessels, is widely used in laparoscopic surgery, but there is little experience in open thyroidectomy. The technique of thyroidectomy has undergone little change in several decades.

Parathyroid surgery knot tying