Skip to main content

Advertisement

Log in

Prospective Randomized Trial of Ligasure Versus Harmonic Hemostasis Technique in Thyroidectomy

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Two surgical devices have become popular in thyroid surgery: a bipolar energy sealing system (B) and ultrasonic coagulation (UC). Retrospective and prospective studies have demonstrated that the use of these surgical devices for thyroidectomy compared with conventional thyroidectomy (clamp-and-tie) techniques reduces operative time and cost. We conducted a prospective randomized clinical trial to determine if there is any difference in operative time and cost between B and UC.

Materials and Methods

A single-blinded prospective randomized controlled trial was conducted at a tertiary referral center. A total of 90 patients who required a thyroidectomy for thyroid cancer, thyroid nodules, or hyperthyroidism were randomized to either B or UC during thyroidectomy. The operative time and cost of thyroidectomy were compared between the two groups.

Results

There was no statistically significant difference in patient age, gender, body mass index, indication for thyroidectomy and thyroid gland weight between the two groups. There was no statistically significant difference in operating room cost or total cost for thyroidectomy between the B and UC groups. There was also no statistically significant difference in the operative time between the B and UC groups (187.6 vs. 184.2 min, P = 0.48) or in postoperative complication rates. The only statistically significant difference in total cost was between surgeons independent of the device used (P < 0.01).

Conclusions

In thyroid surgery, total cost and operative time were similar between the two surgical devices used.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Giddings AE. The history of thyroidectomy. J R Soc Med. 1998;91 Suppl 33:3–6.

    PubMed  Google Scholar 

  2. Cordon C, Fajardo R, Ramirez J, Herrera MF. A randomized, prospective, parallel group study comparing the Harmonic Scalpel to electrocautery in thyroidectomy. Surgery. 2005;137:337–41.

    Article  PubMed  Google Scholar 

  3. Franko J, Kish KJ, Pezzi CM, Pak H, Kukora JS. Safely increasing the efficiency of thyroidectomy using a new bipolar electrosealing device (LigaSure) versus conventional clamp-and-tie technique. Am Surg. 2006;72:132–6.

    PubMed  Google Scholar 

  4. Kirdak T, Korun N, Ozguc H. Use of ligasure in thyroidectomy procedures: results of a prospective comparative study. World J Surg. 2005;29:771–4.

    Article  PubMed  Google Scholar 

  5. Kiriakopoulos A, Dimitrios T, Dimitrios L. Use of a diathermy system in thyroid surgery. Arch Surg. 2004;139:997–1000.

    Article  PubMed  Google Scholar 

  6. Miccoli P, Berti P, Dionigi GL, D’Agostino J, Orlandini C, Donatini G. Randomized controlled trial of harmonic scalpel use during thyroidectomy. Arch Otolaryngol Head Neck Surg. 2006;132:1069–73.

    Article  PubMed  Google Scholar 

  7. Ortega J, Sala C, Flor B, Lledo S. Efficacy and cost-effectiveness of the UltraCision harmonic scalpel in thyroid surgery: an analysis of 200 cases in a randomized trial. J Laparoendosc Adv Surg Tech A. 2004;14:9–12.

    Article  PubMed  Google Scholar 

  8. Parmeggiani U, Avenia N, De Falco M, Parmeggiani D, Pisaniello D, d’Ajello M, Monacelli M, Calzolari F, Sanguinetti A, Sperlongano P. Major complications in thyroid surgery: utility of bipolar vessel sealing (Ligasure Precise). G Chir. 2005;26:387–94.

    PubMed  CAS  Google Scholar 

  9. Petrakis IE, Kogerakis NE, Lasithiotakis KG, Vrachassotakis N, Chalkiadakis GE. LigaSure versus clamp-and-tie thyroidectomy for benign nodular disease. Head Neck. 2004;26:903–9.

    Article  PubMed  Google Scholar 

  10. Shemen L. Thyroidectomy using the harmonic scalpel: analysis of 105 consecutive cases. Otolaryngol Head Neck Surg. 2002;127:284–8.

    Article  PubMed  Google Scholar 

  11. Shen WT, Baumbusch MA, Kebebew E, Duh QY. Use of the electrothermal vessel sealing system versus standard vessel ligation in thyroidectomy. Asian J Surg. 2005;28:86–9.

    Article  PubMed  CAS  Google Scholar 

  12. Siperstein AE, Berber E, Morkoyun E. The use of the harmonic scalpel vs. conventional knot tying for vessel ligation in thyroid surgery. Arch Surg. 2002;137:137–42.

    Article  PubMed  Google Scholar 

  13. Pons Y, Gauthier J, Ukkola-Pons E, Clement P, Roguet E, Poncet JL, Conessa C. Comparison of LigaSure vessel sealing system, harmonic scalpel, and conventional hemostasis in total thyroidectomy. Otolaryngol Head Neck Surg. 2009;141:496–501.

    Article  PubMed  Google Scholar 

  14. McNally MM, Agle SC, Williams RF, Pofahl WE. A comparison of two methods of hemostasis in thyroidectomy. Am Surg. 2009;75:1073–6.

    PubMed  Google Scholar 

Download references

Disclosure

This study was sponsored by Covidien.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Electron Kebebew MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rahbari, R., Mathur, A., Kitano, M. et al. Prospective Randomized Trial of Ligasure Versus Harmonic Hemostasis Technique in Thyroidectomy. Ann Surg Oncol 18, 1023–1027 (2011). https://doi.org/10.1245/s10434-010-1251-5

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-010-1251-5

Keywords

Navigation