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Comparison of the harmonic focus and the thunderbeat for open thyroidectomy

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Abstract

Purpose

An effective method for controlling haemostasis during open thyroidectomy procedures is crucial because of the high risks of haemorrhage and neck haematoma. This study aimed to demonstrate the efficacy of the integrated ultrasonic/bipolar Thunderbeat™ for this procedure.

Methods

This retrospective non-inferiority study compared the Thunderbeat™ and the ultrasonic Harmonic Focus® devices in 761 consecutive patients receiving a partial or total open thyroidectomy (with or without neck dissection). The main outcomes were duration of surgery, blood loss, and length of hospitalisation. Secondary outcomes were occurrence of hypocalcaemia, recurrent nerve paralysis, or other post-operative complications. A non-inferiority logistic regression approach was used to evaluate primary outcomes, adjusting for age, gender, body mass index, type of surgery, anaesthesiology score, and indication (benign or malign).

Results

The data demonstrated that the Thunderbeat was non-inferior to the Focus in terms of duration of surgery, blood loss, and length of hospital stay. Furthermore, subgroup analyses showed non-inferiority of the Thunderbeat for partial thyroidectomy (all three outcomes), total thyroidectomy (duration of surgery and length of hospitalisation), and total thyroidectomy with neck dissection (length of hospitalisation). In terms of recurrent nerve paralysis and post-operative complications, the Thunderbeat performed at least as well as the Focus; however, no conclusions could be drawn regarding the occurrence of post-operative hypocalcaemia.

Conclusion

In a cohort of patients that underwent partial or total thyroidectomy, the Thunderbeat appeared to be at least as good as the Harmonic Focus.

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Acknowledgement

We would like to thank Peter Konings, senior bio-statistician, for his advice considering the non-inferiority method.

Author contributions

This study was designed by SV, NB, and JM. Data collection was performed by SV and KV. The statistical analyses were performed by NB. NB and SV interpreted the results. The writing and revisions of the manuscript were performed by SV, NB, and JM. Critical evaluation of the manuscript and results was performed by all authors. All authors approved the final manuscript for submission.

Disclosures

JM has received honoraria for consultancy from Olympus.

Author information

Authors and Affiliations

  1. Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Clinic Aalst, Moorselbaan 164, 9300, Aalst, Belgium

    Sam Van Slycke, Jean-Pierre Gillardin & Klaas Van Den Heede

  2. Department of Head, Neck and Maxillofacial Surgery, University Hospital Ghent, De Pintelaan 185, 9000, Ghent, Belgium

    Sam Van Slycke & Hubert Vermeersch

  3. European Institute of Cancer Research, Carrer del Passeig 2, 08221, Terrassa, Barcelona, Spain

    Joan Minguet

  4. Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Norra Stationsgatan 67, 17176, Stockholm, Sweden

    Nele Brusselaers

Authors
  1. Sam Van Slycke
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  2. Jean-Pierre Gillardin
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  3. Klaas Van Den Heede
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  4. Joan Minguet
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  5. Hubert Vermeersch
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  6. Nele Brusselaers
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Corresponding author

Correspondence to Sam Van Slycke.

Ethics declarations

Conflict of interest

SVS declares that he has no conflict of interest.

J-PG declares that he has no conflict of interest.

KVDH declares that he has no conflict of interest.

JM has received honoraria for consultancy from Olympus.

HV declares that he has no conflict of interest.

NB declares that she has no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Van Slycke, S., Gillardin, JP., Van Den Heede, K. et al. Comparison of the harmonic focus and the thunderbeat for open thyroidectomy. Langenbecks Arch Surg 401, 851–859 (2016). https://doi.org/10.1007/s00423-016-1448-6

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  • DOI: https://doi.org/10.1007/s00423-016-1448-6

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