Skip to main content
SpringerLink
Log in

Risk of Complications with Energy-Based Surgical Devices in Thyroid Surgery: A National Multicenter Register Study

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Energy-based surgical devices (EBD) combining cutting and coagulation are increasingly used in thyroid surgery. However, there is a lack of information about potential benefits and risk of complications outside controlled trials. The aims of this national multicenter register study were to describe the use of EDB, their potential effect on complication rates, and on operation time.

Materials and methods

The Scandinavian Quality Register for Thyroid and Parathyroid surgery includes 35 surgical units in Sweden and covered 88 % of the thyroid procedures performed during 2008–2009. The use of the EBD was specifically registered for 12 months, and 1297 patients were included. Surgically related complications and operation time were evaluated. The clamp-and-tie group (C-A-T) constituted the control group for comparison with procedures where EBD was used.

Results

The thyroid procedures performed included C-A-T (16.6 %), bipolar electrosurgery (ES: 56.5 %), electronic vessel sealing (EVS: 12.2 %), and ultrasonic dissection (UD: 14.5 %). Mean operative time was longer with EVS (p < 0.001) and shorter with UD (p < 0.05) than in the other groups. The bipolar ES group and the EVS group had higher incidence of calcium treatment at discharge and after 6 weeks than the UD group. No significant difference in nerve injury was found between the groups. There was a significant more frequent use of topical hemostatic agents in the EBD group compared to C-A-T.

Conclusion

In this national multicenter study, the use of UD shortened and EVS increased operating time. There was a higher risk of calcium treatment at discharge and after 6 weeks after use of EVS and bipolar ES than after UD use. There was a significant more frequent use of topical hemostatic agents in the EBD groups compared to C-A-T.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sankaranarayanan G et al (2013) Common uses and cited complications of energy in surgery. Surg Endosc 27(9):3056–3072

    Article  PubMed  PubMed Central  Google Scholar 

  2. Carlander J et al (2005) Comparison of experimental nerve injury caused by ultrasonically activated scalpel and electrosurgery. Br J Surg 92(6):772–777

    Article  PubMed  CAS  Google Scholar 

  3. Carlander J et al (2012) Heat production, nerve function, and morphology following nerve close dissection with surgical instruments. World J Surg 36(6):1361–1367. doi:10.1007/s00268-012-1471-x

    Article  PubMed  Google Scholar 

  4. Rahbari R et al (2011) Prospective randomized trial of ligasure versus harmonic hemostasis technique in thyroidectomy. Ann Surg Oncol 18(4):1023–1027

    Article  PubMed  Google Scholar 

  5. Garas G et al (2013) Which hemostatic device in thyroid surgery? A network meta-analysis of surgical technologies. Thyroid 23(9):1138–1150

    Article  PubMed  Google Scholar 

  6. Lang BH et al (2013) A systematic review and meta-analysis comparing the efficacy and surgical outcomes of total thyroidectomy between harmonic scalpel versus ligasure. Ann Surg Oncol 20(6):1918–1926

    Article  PubMed  Google Scholar 

  7. Contin P et al (2013) ENERgized vessel sealing systems versus CONventional hemostasis techniques in thyroid surgery–the ENERCON systematic review and network meta-analysis. Langenbecks Arch Surg 398(8):1039–1056

    Article  PubMed  Google Scholar 

  8. Pons Y et al (2009) Comparison of LigaSure vessel sealing system, harmonic scalpel, and conventional hemostasis in total thyroidectomy. Otolaryngol Head Neck Surg 141(4):496–501

    Article  PubMed  Google Scholar 

  9. Bove A et al (2012) Thyroid surgery with harmonic focus, ligasure precise and conventional technique: a retrospective case-matched study. Hippokratia 16(2):154–159

    PubMed  CAS  PubMed Central  Google Scholar 

  10. Sartori PV et al (2008) Ligasure versus Ultracision in thyroid surgery: a prospective randomized study. Langenbecks Arch Surg 393(5):655–658

    Article  PubMed  Google Scholar 

  11. Miccoli P et al (2006) Randomized controlled trial of harmonic scalpel use during thyroidectomy. Arch Otolaryngol Head Neck Surg 132(10):1069–1073

    Article  PubMed  Google Scholar 

  12. Franko J et al (2006) Safely increasing the efficiency of thyroidectomy using a new bipolar electrosealing device (LigaSure) versus conventional clamp-and-tie technique. Am Surg 72(2):132–136

    PubMed  Google Scholar 

  13. Goretzki PE, Schwarz K, Lammers BJ (2009) Implementing the general use of dissection devices in thyroid surgery from prospective randomized trial to daily use. Surg Technol Int 18:86–92

    PubMed  Google Scholar 

  14. Cordon C et al (2005) A randomized, prospective, parallel group study comparing the Harmonic Scalpel to electrocautery in thyroidectomy. Surgery 137(3):337–341

    Article  PubMed  Google Scholar 

  15. Teksoz S et al (2013) Sutureless thyroidectomy with energy-based devices: cerrahpasa experience. Updates Surg 65(4):301–307

    Article  PubMed  Google Scholar 

  16. Ambrosi A, Fersini A, Samele F, Tartaglia N, Prete FP, Natale F et al (2006) Employment of new technologies in thyroid surgery. Langenbecks Arch Surg 391:47–48

    Article  Google Scholar 

  17. Rosato L et al (2004) Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg 28(3):271–276. doi:10.1007/s00268-003-6903-1

    Article  PubMed  Google Scholar 

  18. Bergenfelz A et al (2008) Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients. Langenbecks Arch Surg 393(5):667–673

    Article  PubMed  CAS  Google Scholar 

  19. Pergel A et al (2014) A safety-based comparison of pure LigaSure use and LigaSure-tie technique in total thyroidectomy. Chirurgia (Bucur) 109(1):60–65

    CAS  Google Scholar 

  20. Petrakis IE et al (2004) LigaSure versus clamp-and-tie thyroidectomy for benign nodular disease. Head Neck 26(10):903–909

    Article  PubMed  Google Scholar 

  21. Chang LY et al (2011) Sutureless total thyroidectomy: a safe and cost-effective alternative. ANZ J Surg 81(7–8):510–514

    Article  PubMed  Google Scholar 

  22. Hallgrimsson P et al (2012) Risk factors for medically treated hypocalcemia after surgery for Graves’ disease: a Swedish multicenter study of 1,157 patients. World J Surg 36(8):1933–1942. doi:10.1007/s00268-012-1574-4

    Article  PubMed  CAS  Google Scholar 

  23. Schiphorst AH et al (2012) Randomized clinical trial of LigaSure versus conventional suture ligation in thyroid surgery. Head Neck Oncol 4:2

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

FORSS (Forskningsrådet i Sydöstra Sverige).

Author information

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

    Johan Carlander, Oliver Gimm & Kenth Johansson

  2. Deparment of Surgery, Linköping University Hospital, Linköping, Sweden

    Oliver Gimm

  3. Department of Surgery, Lund University Hospital, Malmö, Sweden

    Erik Nordenström

  4. Department of Surgery, Sahlgrenska University Hospital Gothenburg, Göteborg, Sweden

    Svante Jansson & Kenth Johansson

  5. Department of Surgery and Center for Clinical Research Uppsala University, Västmanland County Hospital, 72189, Västerås, Sweden

    Johan Carlander, Philippe Wagner & Leif Bergkvist

  6. Department Surgery, Västervik Hospital, Västervik, Sweden

    Kenth Johansson

Authors
  1. Johan Carlander
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Philippe Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Oliver Gimm
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Erik Nordenström
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Svante Jansson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Leif Bergkvist
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kenth Johansson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Johan Carlander.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Carlander, J., Wagner, P., Gimm, O. et al. Risk of Complications with Energy-Based Surgical Devices in Thyroid Surgery: A National Multicenter Register Study. World J Surg 40, 117–123 (2016). https://doi.org/10.1007/s00268-015-3270-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-015-3270-7

Keywords

Search

Navigation