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Thyroidectomy with LigaSure

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Abstract

Purpose

A new method for ensuring hemostasis during thyroid surgery has recently been introduced. This technique, electrothermal (LigaSure) and ultrasound blood vessel sealing, is still experimental. The aim of the present study was to evaluate the applications and efficacy of LigaSure by analyzing the duration of the surgery and the rate of complications of the surgical procedure.

Methods

A total of 23 patients who underwent the LigaSure operation (nLS group) were analyzed in a prospective nonrandomized/partly randomized clinical study, and were compared with patients who underwent treatment using the conventional (ligature) surgical technique.

Results

At our institutions, 187 patients were treated surgically for thyroid disease in 2006, and 23 of these patients were treated using LigaSure. The complication rate in the patients treated with LigaSure (nLS: 4.3%) was lower than those who received conventional ligature surgery. However, given the small number of patients, this difference was not statistically significant (retrospective group n1: 10.7%; nonrandomized group n2: 9.8%; and randomized group n3: 9.1%). The length of surgery in the LigaSure group (nLS = 65 ± 3 min) was significantly shorter (P < 0.001) compared with both nonrandomized (n2 = 71 ± 6 min) and randomized (n3 = 70 ± 4 min) patients who received a conventional ligature.

Conclusions

The application of LigaSure using meticulous surgical technique provides a new option for a safe thyroidectomy. Moreover, the duration of the LigaSure procedure is significantly shorter, and there are fewer complications as compared with the classic surgical thyroidectomy technique.

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References

  1. Ignjatović M, Çuk V, Ožegović A, Cerović S, Kostić Z, Romić P. Early complications in surgical treatment of thyroid diseases: analysis of 2100 patients (in Serbian). Acta Chir Iugosl 2003;50(3):155–175.

    PubMed  Google Scholar 

  2. Riegler M, Cosentini E. Update on LigaSure®/Atlas® vessel sealing technology in general surgery. Eur Surg 2004;36/2:85–88.

    Article  Google Scholar 

  3. Richter S, Kollmar O, Schilling MK, Pistorius GA, Menger MD. Efficacy and quality of vessel sealing: comparison of a reusable with a disposable device and effects of clamp surface geometry and structure. Surg Endosc 2006;20(6):890–894.

    Article  PubMed  CAS  Google Scholar 

  4. Harold KL, Pollinger H, Matthews BD, Kercher KW, Sing RF, Heniford BT. Comparison of ultrasonic energy, bipolar thermal energy, and vascular clips for the hemostasis of small-, medium-, and large-sized arteries. Surg Endosc 2003;17(8):1228–1230.

    Article  PubMed  CAS  Google Scholar 

  5. Richter S, Kollmar O, Neunhoeffer E, Schilling MK, Menger MD, Pistorius G. Differential response of arteries and veins to bipolar vessel sealing: evaluation of a novel reusable device. J Laparoendosc Adv Surg Tech A 2006;16(2):149–155.

    Article  PubMed  Google Scholar 

  6. Phillips CK, Hruby GW, Durak E, Lehman DS, Humphrey PA, Mansukhani MM, et al. Tissue response to surgical energy devices. Urology 2008;71(4):744–748.

    Article  PubMed  Google Scholar 

  7. Campbell PA, Cresswell AB, Frank TG, Cuschieri A. Real-time thermography during energized vessel sealing and dissection. Surg Endosc 2003;17(10):1640–1645.

    Article  PubMed  CAS  Google Scholar 

  8. Diamantis T, Kontos M, Arvelakis A, Syroukis S, Koronarchis D, Papalois A, et al. Comparison of monopolar electrocoagulation, bipolar electrocoagulation, Ultracision, and Ligasure. Surg Today 2006;36(10):908–913.

    Article  PubMed  Google Scholar 

  9. Rajbabu K, Barber NJ, Choi W, Muir GH. To knot or not to knot? Sutureless haemostasis compared to the surgeon’s knot. Ann R Coll Surg Engl 2007;89(4):359–362.

    Article  PubMed  CAS  Google Scholar 

  10. Kim FJ, Chammas MF Jr, Gewehr E, Morihisa M, Caldas F, Hayacibara E, et al. Temperature safety profile of laparoscopic devices: Harmonic ACE (ACE), Ligasure V (LV), and plasma trisector (PT). Surg Endosc 2008;22(6):1464–1469.

    Article  PubMed  CAS  Google Scholar 

  11. Diamantis T, Gialikaris S, Kontos M, Gakiopoulou C, Felekouras E, Papalois A, et al. Comparison of safety and efficacy of ultrasonic and bipolar thermal energy: an experimental study. Surg Laparosc Endosc Percutan Tech 2008;18(4):384–390.

    Article  PubMed  Google Scholar 

  12. Kennedy JS, Stranahan PL, Taylor KD, Chandler JG. High-burststrength, feedback-controlled bipolar vessel sealing. Surg Endosc 1998;12(6):876–878.

    Article  PubMed  CAS  Google Scholar 

  13. Valleylab. LigaSure™. Clinical benefits for both the surgeon and patient. Valleylab, a division of Tyco Healthcare Group LP. Available from URL: http://www.ligasure.com/pages/benefits.htm. Accessed February 10, 2009

  14. Vaiman M, Nagibin A, Olevson J. Complications in primary and completed thyroidectomy. Surg Today 2010;40(2):114–118.

    Article  PubMed  Google Scholar 

  15. Barbaros U, Erbil Y, Bozbora A, Deveci U, Aksakal N, Dinççağ A, et al. The use of LigaSure in patients with hyperthyroidism. Langenbecks Arch Surg 2006;391(6):575–579.

    Article  PubMed  Google Scholar 

  16. Goretzki PE, Pohl P, Terörde N, Krause-Paulus RM, Lammers BJ. Neue Methoden in der Schilddrüsenchirurgie — Die ligaturfreie Präparation und Resektion mit LigaSureTM [New methods in thyroid surgery — the ligation free preparation and dissection with LigaSureTM]. Viszeralchirurgie 2005;40:214–218.

    Article  Google Scholar 

  17. Petrakis IE, Kogerakis NE, Lasithiotakis KG, Vrachassotakis N, Chalkiadakis GE. LigaSure versus clamp-and-tie thyroidectomy for benign nodular disease. Head Neck 2004;26(10):903–909.

    Article  PubMed  Google Scholar 

  18. Lepner U, Vaasna T. Ligasure vessel sealing system versus conventional vessel ligation in thyroidectomy. Scand J Surg 2007;96(1):31–34.

    PubMed  CAS  Google Scholar 

  19. Youssef T, Mahdy T, Farid M, Latif AA. Thyroid surgery: use of the LigaSure Vessel Sealing System versus conventional knot tying. Int J Surg 2008;6(4):323–327.

    Article  PubMed  Google Scholar 

  20. Macario A, Dexter F, Sypal J, Cosgriff N, Heniford BT. Operative time and other outcomes of the electrothermal bipolar vessel sealing system (LigaSure™) versus other methods for surgical hemostasis: a meta-analysis. Surg Innov 2008;15(4):284–291.

    Article  PubMed  Google Scholar 

  21. Cipolla C, Graceffa G, Sandonato L, Fricano S, Vieni S, Latteri MA. LigaSure in total thyroidectomy. Surg Today 2008;38(6):495–498.

    Article  PubMed  Google Scholar 

  22. Kiriakopoulos A, Dimitrios T, Dimitrios L. Use of a diathermy system in thyroid surgery. Arch Surg 2004;139(9):997–1000.

    Article  PubMed  Google Scholar 

  23. Inabnet WB, Shifrin A, Ahmed L, Sinha P. Safety of same day discharge in patients undergoing sutureless thyroidectomy: a comparison of local and general anesthesia. Thyroid 2008;18(1):57–61.

    Article  PubMed  Google Scholar 

  24. Dilek ON, Yilmaz S, Degirmenci B, Ali Sahin D, Akbulut G, Dilek FH. The use of a vessel sealing system in thyroid surgery. Acta Chir Belg 2005;105(4):369–372.

    PubMed  CAS  Google Scholar 

  25. Musunuru S, Schaefer S, Chen H. The use of the Ligasure for hemostasis during thyroid lobectomy. Am J Surg 2008;195(3):382–385.

    Article  PubMed  Google Scholar 

  26. Parmeggiani U, Avenia N, De Falco M, Parmeggiani D, Pisaniello D, d’Ajello M, et al. Major complications in thyroid surgery: utility of bipolar vessel sealing (Ligasure Precise). G Chir 2005;26(10):387–394.

    PubMed  CAS  Google Scholar 

  27. Fujita T, Doihara H, Ogasawara Y, Simizu N. Utility of vesselsealing systems in thyroid surgery. Acta Med Okayama 2006;60(2):93–98.

    PubMed  Google Scholar 

  28. Samraj K, Gurusamy KS. Wound drains following thyroid surgery. Cochrane Database Syst Rev. 2007;4:CD006099.

    Google Scholar 

  29. Lachanas VA, Prokopakis EP, Mpenakis AA, Karatzanis AD, Velegrakis GA. The use of Ligasure Vessel Sealing System in thyroid surgery. Otolaryngol Head Neck Surg 2005;132(3):487–489.

    Article  PubMed  Google Scholar 

  30. Kilic I, Sunamak O, Aydogan F, Sen B, Altintas B, Duren M, et al. LigaSure Precise? use in thyroid operations: a comparison with the conventional method. Eur Surg 2007:39(1):54–56.

    Article  Google Scholar 

  31. Saint Marc O, Cogliandolo A, Piquard A, Famà F, Pidoto RR. LigaSure vs clamp-and-tie technique to achieve hemostasis in total thyroidectomy for benign multinodular goiter: a prospective randomized study. Arch Surg 2007;142(2):150–157.

    Article  PubMed  Google Scholar 

  32. Minner S, Rödiger H, Mansmann U, Böhm B. Randomized controlled trial on vessel sealing in thyroid surgery (in German). Zentralbl Chir 2007;132(5):446–450.

    Article  PubMed  CAS  Google Scholar 

  33. Kirdak T, Korun N, Ozguc H. Use of ligasure in thyroidectomy procedures: results of a prospective comparative study. World J Surg 2005;29(6):771–774.

    Article  PubMed  Google Scholar 

  34. Manouras A, Markogiannakis H, Koutras AS, Antonakis PT, Drimousis P, Lagoudianakis EE, et al. Thyroid surgery: comparison between the electrothermal bipolar vessel sealing system, harmonic scalpel, and classic suture ligation. Am J Surg 2008;195(1):48–52.

    Article  PubMed  Google Scholar 

  35. Sandonato L, Cipolla C, Graceffa G, Fricano S, Li Petri S, Prinzi G, et al. Bipolar electrothermic coagulation (ligasure bipolar vessel sealing system) in thyroid surgery (in Italian). Chir Ital 2003;55(3):411–415.

    PubMed  Google Scholar 

  36. 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(2):86–89.

    Article  PubMed  CAS  Google Scholar 

  37. Manouras A, Markogiannakis HE, Kekis PB, Lagoudianakis EE, Fleming B. Novel hemostatic devices in thyroid surgery: electrothermal bipolar vessel sealing system and harmonic scalpel. Expert Rev Med Devices 2008;5(4):447–466.

    Article  PubMed  Google Scholar 

  38. Sartori PV, De Fina S, Colombo G, Pugliese F, Romano F, Cesana G, et al. Ligasure versus Ultracision(R) in thyroid surgery: a prospective randomized study. Langenbecks Arch Surg 2008;393(5):655–658.

    Article  PubMed  Google Scholar 

  39. 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(2):132–136.

    PubMed  Google Scholar 

  40. Marrazzo A, Casà L, David M, Lo Gerfo D, Noto A, Riili I, et al. Thyroidectomy with LigaSure versus traditional thyroidectomy: our experience (in Italian). Chir Ital 2007;59(3):361–365.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Surgical Clinic, Clinical-Hospital Centre Zvezdara, Nikola Spasić, Dimitrija Tucovića 161, 11000, Belgrade, Serbia

    Mile Ignjatović

  2. Clinic for Abdominal and Endocrine Surgery, Military Medical Academy, Belgrade, Serbia

    Zoran Kostić

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  1. Mile Ignjatović
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  2. Zoran Kostić
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Ignjatović, M., Kostić, Z. Thyroidectomy with LigaSure. Surg Today 41, 767–773 (2011). https://doi.org/10.1007/s00595-010-4364-3

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  • DOI: https://doi.org/10.1007/s00595-010-4364-3

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