scholarly journals Focus Harmonic Scalpel Compared to Conventional Haemostasis in Open Total Thyroidectomy: A Prospective Randomized Trial

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Emanuele Ferri ◽  
Enrico Armato ◽  
Giacomo Spinato ◽  
Roberto Spinato
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Randomized Trial ◽  
Total Thyroidectomy ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Thyroid Volume ◽  
Prospective Randomized Trial ◽  
Drainage Volume ◽  
Significant Difference

The aim of this prospective randomized trial was to compare operative factors, postoperative outcomes and surgical complications of open total thyroidectomy when using the Harmonic Scalpel (HS) versus Conventional Haemostasis (CH).Methods. 100 consecutive patients underwent open total thyroidectomy were randomized into two groups: group CH (Conventional Haemostasis) and group HS (Harmonic Scalpel). We recorded the following: age, sex, pathology, thyroid volume, haemostatic technique, operative time, drainage volume, thyroid weight, postoperative pain, postoperative complications, and hospital stay. The results were analyzed using the Student’sttest and test.Results. No significant difference was found between the two groups concerning mean thyroid weight and mean hospital stay. The mean operative time was significantly shorter in the HS group. The total drainage fluid volume was lower in HS group. Two (4%) transient recurrent laryngeal nerve palsies were observed in CH group and no one (0%) in the HS group. Postoperative transient hypocalcemia occurred more frequently in the CH group. HS group experienced significantly less postoperative pain at 24 and 48 hours.Conclusions. In patients undergoing thyroidectomy, HS is a reliable and safe tool. Comparing with CH techniques, its use reduces operative times, postoperative pain, drainage volume and transient hypocalcemia.

scholarly journals Harmonic scalpel thyroidectomy versus conventional haemostasis thyroidectomy

2021 ◽  
Vol 8 (2) ◽  
pp. 559
Author(s):  
Ajaz U. Haq ◽  
Tariq Mahmood ◽  
Sheetal Kumari ◽  
Aneesa Afzal
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Jammu And Kashmir ◽  
Drainage Volume ◽  
Informed Consent Form ◽  
Significant Difference ◽  
The Mean ◽  
Operative Drainage

Background: As there is paucity of data on harmonic scalpel thyroidectomy from Jammu and Kashmir belt. So, we conducted this study to bridge this gap and also to create awareness about the use of harmonic scalpel. Thyroidectomy has become one of the most common and frequent surgery. Hemostasis in thyroid surgery is of utmost importance for a successful surgery. Our aim was to compare operative factors, postoperative outcomes of thyroidectomy using the Harmonic Scalpel (HS) and Conventional Haemostasis (CH).Methods: In this randomized control trial study, 100 patients who underwent thyroidectomy were enrolled and randomly divided in two groups- HS group and CH group. The inclusion criteria were age>18years, acceptance to participate in the study (signed informed consent form) and scheduled total thyroidectomy. The groups were compared with regards to age, gender, operative time, post-operative drainage volume, postoperative pain, and hospital stay.Results: The mean age in years was 39.8 years for HS group and 43.8 years for CH group with female preponderance. There was a significant difference with regards to operative time, post-operative drainage volume, postoperative pain, and hospital stay (p<0.001). Harmonic Scalpel shortens the operative time. And there was less post-operative drainage volume and postoperative pain in HS group. Hospital stay was also less as compared to CH group.Conclusions: HS is superior then CH thyroidectomy and is considered as a safe and better tool in thyroidectomy.

scholarly journals Merits of harmonic scalpel over conventional hemostasis in open thyroid surgery: a randomised controlled trial

2019 ◽  
Vol 6 (1) ◽  
pp. 186
Author(s):  
Anushree Bajaj ◽  
Bhalchandra Paike ◽  
Shahnaz Sheikh ◽  
Vikrant Vaze
Keyword(s):  
Hospital Stay ◽  
Thyroid Surgery ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Controlled Trial ◽  
Thyroid Volume ◽  
Drainage Fluid ◽  
Drainage Volume ◽  
Post Operative Pain ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> The pioneers of thyroid surgery, Theodor Kocher and Theodor Billroth, developed an acceptable technique of standardized thyroid surgery between 1873 and 1883. The aim of this prospective randomized trial was to evaluate the efficacy and safety of harmonic scalpel use compared with conventional haemostasis in open thyroid surgery.</p><p class="abstract"><strong>Methods:</strong> A total of 60 consecutive patients underwent open total thyroidectomy were randomized into two groups. Group A with harmonic scalpel and Group B with electrocautery with 30 patients each. Factors including age, sex, pathology, thyroid volume, haemostatic technique, operative time, drainage volume, thyroid weight, postoperative pain, postoperative complications and hospital stay. The results were analysed using the students t-test and x<sup>2</sup>.</p><p class="abstract"><strong>Results:</strong> No significant difference was found between the two groups concerning mean thyroid weight and mean hospital stay. The mean operative time was shorter in the harmonic scalpel group. The total fluid drainage fluid volume was lower in Harmonic scalpel group shorter in. Harmonic scalpel group experienced significantly less post-operative pain at 24 and 48 hours.</p><p class="abstract"><strong>Conclusions:</strong> In patients undergoing thyroidectomy, harmonic scalpel is a reliable and safe tool. AS compared with conventional haemostasis techniques, its use reduces operative times, post-operative pain, drainage volume and transient hypocalcemia.</p>

scholarly journals The Safety and Efficacy of Cervical Laminectomy and Fusion versus Cervical Laminoplasty Surgery in Degenerative Cervical Myelopathy: A Prospective Randomized Trial

2020 ◽  
Vol 8 (B) ◽  
pp. 807-814
Author(s):  
Mohamed Elmallawany ◽  
Haitham Kandel ◽  
Mohamed A. R. Soliman ◽  
Tarek Ahmed Tareef ◽  
Ahmed Atallah ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Randomized Trial ◽  
Operative Time ◽  
Prospective Randomized Trial ◽  
Cervical Laminectomy ◽  
Significant Difference ◽  
Operative Complications ◽  
Cobb’S Angle ◽  
The Mean ◽  
Degenerative Cervical Myelopathy

BACKGROUND: There is a lack of evidence of whether degenerative cervical myelopathy (DCM) is best treated through cervical laminoplasty (CLP) or cervical laminectomy with lateral mass fusion due to the lack of prospective randomized studies that are well designed. We conducted the largest prospective randomized trial to date to determine the comparative effectiveness and safety of both approaches. METHODS: In this prospective, randomized trial, we randomly assigned patients who had symptoms or signs of DCM to undergo either cervical laminectomy and lateral mass fixation (CLF) or CLP. The primary outcome measures were the change in the Visual Analog Scale (VAS), neck disability index, modified Japanese Orthopedic Association (mJOA) score, and Nurick’s myelopathy grading 1 year after surgery. The secondary outcome measures were the intraoperative, post-operative complications, hospital stay, C2-7 Cobb’s angle, and Odom’s criteria. The follow-up period was at least 1 year. RESULTS: A total of 30 patients (mean age, 54.5 ± 5.5 years, 70% of men) underwent prospective randomization. There was a significantly greater improvement in neck pain (VAS) in the CLF group at 1 year (p < 0.05). The improvement in the mJOA and Nurick’s myelopathy grading showed insignificant improvement between both groups. Furthermore, there was no significant difference in the patient’s post-operative satisfaction (Odom’s criteria). The mean operative time was significantly longer in the CLF group (p < 0.001), with no significant difference in the post-operative complications, however, there was a higher rate of C5 palsy, dural tear and infection in the CLF, and a higher rate of instrumentation failure in the CLP. The mean hospital stay was significantly longer in the posterior group (p < 0.05). Finally, there was a significant better improvement in the C2-7 Cobb’s angle at 1 year in the CLF group (p < 0.05). CONCLUSION: Among patients with multilevel DCM, the CLF approach was significantly better regarding the post-operative pain and Cobb’s angle while the CLP was significantly better in terms of shorter hospital stay and operative time.

scholarly journals Differences in Surgical Outcome in Near Total Thyroidectomy for Benign Nodular Goiter: A Comparison of LigaSure Vessel Sealer versus Conventional Clamp Knot Tie Technique

2021 ◽  
pp. 65-69
Author(s):  
Shiraz Shaikh ◽  
Champa Sushel ◽  
Ahsan Ali Laghari ◽  
Qamber Ali Laghari ◽  
Zameer Hussain Laghari ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Total Thyroidectomy ◽  
Calcium Level ◽  
Operative Time ◽  
Nodular Goiter ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Post Operative Pain ◽  
Significant Difference ◽  
One Year

Objective: To compare the efficacy of LigaSure Vessel Sealer in Near Total Thyroidectomy versus Conventional Clamp Knot Tie Technique in terms of bleeding, operative time and postoperative drainage. Methodology: This comparative cross sectional study was conducted at Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro. Study duration was one year from November 2019 to October 2020. All patients of any age with benign multinodular goiter and either of gender were included. The study subjects were grouped into two categories by randomization (odd / even). The odd numbers were given to patients operated for ligasure and even numbers were given to patients operated with conventional clamp knot tie technique.  Outcomes were observed with respect to post-operative calcium level, intra-operative bleeding, operative time, post-operative pain & post-operative hospital stay. All the data was recorded via study proforma. Data was analyzed by using SPSS version 20. Results: Total 55 patients were observed. Mean age was 33.25±10.60 years in clamp knot tie procedure group and 35.16±07.96 years in ligasure technique group; without significant difference (p-0.448). Pre and post-operative calcium levels were statistically insignificant among both groups (p-0.358 and 0.163), while loss of blood, hospital stay, post-operative pain and operative duration were significantly greater in clamp knot tie technique group in comparison to ligasure technique group (p-<0.001). Conclusion: LigaSure Vessel Sealer is a feasible and reliable surgical technique and significantly more effective as compared to conventional clamp knot tie technique in terms of post-operative bleeding, operative time, post-operative pain and post-operative hospital stay. However, calcium level was statistically insignificant.

scholarly journals Drain versus non drain in thyroid surgery

2016 ◽  
Vol 1 (2) ◽  
pp. 26-29
Author(s):  
Fadhil Ahmed Mohialdeen ◽  
Abdul-Wahid M Salih ◽  
Mohammed IM Gubari ◽  
Soran Ameen Hama-law
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Total Thyroidectomy ◽  
Thyroid Surgery ◽  
Length Of Hospital Stay ◽  
Pain Patient ◽  
Histopathological Diagnosis ◽  
Suction Drain ◽  
Significant Difference ◽  
Hospital Stays

The use of a suction drain in thyroid surgery is common practice in order to avoid hematomas or seromas. The aim of this study was to determine the efficacy of inserting a routine drainage tube after thyroid surgery. In this retrospective study, 102 patients who underwent either a total thyroidectomy for thyroid disorders were assigned to either the drained or the non-drained groups. The length of hospital stays, postoperative pain, patient comfortability and complications were retrieved. Both groups were homogeneous according to age, gender, type of procedure performed, histopathological diagnosis residency and marital status. No significant difference was found between the two groups in post- operative complications, but the length of hospital stay was significantly reduced in non-drained group (p<0.0001), and drained group needed one more dose of analgesics compared to non-drained group to alleviate the post-operative pain.Our findings, suggesting that the use of drain for thyroid surgery cannot lower the incidence of complications. Furthermore, the use of drains may increase length of hospital stay, postoperative-pain,and the need of analgesic and contribute to the discomfort of the patients. Hence, the routine insertion of drains after total thyroidectomy for benign disorders might not be necessary.

scholarly journals Harmonic Scalpel versus Conventional Haemostasis in Neck Dissection: A Prospective Randomized Study

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Emanuele Ferri ◽  
Enrico Armato ◽  
Giacomo Spinato ◽  
Marcello Lunghi ◽  
Giancarlo Tirelli ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Neck Dissection ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Intraoperative Blood Loss ◽  
Bipolar Diathermy ◽  
Classic Technique

Purpose.The aim of this prospective randomized trial was to compare operative factors, postoperative outcomes, and surgical complications of neck dissection (ND) when using the harmonic scalpel (HS) versus conventional haemostasis (CH) (classic technique of tying and knots, resorbable ligature, and bipolar diathermy).Materials and methods.Sixty-one patients who underwent ND with primary head and neck cancer (HNSCC) resection were enrolled in this study and were randomized into two homogeneous groups: CH (conventional haemostasis with classic technique of tying and knots, resorbable ligature, and bipolar diathermy) and HS (haemostasis with harmonic scalpel). Outcomes of the study included operative time, intraoperative blood loss, drainage volume, postoperative pain, hospital stay, and incidence of intraoperative and postoperative complications.Results.The use of the HS reduced significantly the operating time, the intraoperative blood loss, the postoperative pain, and the volume of drainage. No significant difference was observed in mean hospital stay and perioperative, and postoperative complications.Conclusion.The HS is a reliable and safe tool for reducing intraoperative blood loss, operative time, volume of drainage and postoperative pain in patients undergoing ND for HNSCC. Multicenter randomized studies need to be done to confirm the advantages of this technique and to evaluate the cost-benefit ratio.

scholarly journals The safety and efficacy of anterior versus posterior decompression surgery in degenerative cervical myelopathy: a prospective randomized trial

2020 ◽  
Vol 33 (3) ◽  
pp. 288-296
Author(s):  
Nasser M. F. El-Ghandour ◽  
Mohamed A. R. Soliman ◽  
Ahmed A. M. Ezzat ◽  
Amr Mohsen ◽  
Mostafa Zein-Elabedin
Keyword(s):  
Hospital Stay ◽  
Randomized Trial ◽  
Prospective Randomized Trial ◽  
Decompression Surgery ◽  
Postoperative Dysphagia ◽  
Posterior Decompression ◽  
Significant Difference ◽  
The Mean ◽  
Degenerative Cervical Myelopathy ◽  
Anterior Group

OBJECTIVEThe safety and efficacy of anterior and posterior decompression surgery in degenerative cervical myelopathy (DCM) have not been validated in any prospective randomized trial.METHODSIn this first prospective randomized trial, the patients who had symptoms or signs of DCM were randomly assigned to undergo either anterior cervical discectomy and fusion or posterior laminectomy with or without fusion. The primary outcome measures were the change in the visual analog scale (VAS) score, Neck Disability Index (NDI), and Nurick myelopathy grade 1 year after surgery. The secondary outcome measures were intraoperative and postoperative complications, hospital stay, and Odom’s criteria. The follow-up period was at least 1 year.RESULTSA total of 68 patients (mean age 53 ± 8.3 years, 72.3% men) underwent prospective randomization. There was a significantly better outcome in the NDI and VAS scores in the anterior group at 1 year (p < 0.05). Nurick myelopathy grading showed nonsignificant improvement using the posterior approach group (p = 0.79). The mean operative duration was significantly longer in the anterior group (p < 0.001). No significant difference in postoperative complications was found, except postoperative dysphagia was significantly higher in the anterior group (p < 0.05). There was no significant difference in postoperative patient satisfaction (Odom’s criteria) (p = 0.52). The mean hospital stay was significantly longer in the posterior group (p < 0.001).CONCLUSIONSAmong patients with multilevel DCM, the anterior approach was significantly better regarding postoperative pain, NDI, and hospital stay, while the posterior approach was significantly better in terms of postoperative dysphagia and operative duration.

scholarly journals Harmonic scalpel compared with conventional open (Milligan-Morgan) method in surgical management of symptomatic haemorrhoids

2017 ◽  
Vol 4 (6) ◽  
pp. 2010
Author(s):  
Ravi Kumar G. V. ◽  
Madhu B. S. ◽  
Vishal Tanga ◽  
Naveen Kumar Reddy M. ◽  
Praveen M. Pawar
Keyword(s):  
Postoperative Pain ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Harmonic Scalpel ◽  
Early Postoperative Complications ◽  
Surgical Methods ◽  
Significant Difference ◽  
Normal Work ◽  
Grade Iii

Background: There have been many attempts to find less painful surgical methods for treating haemorrhoids. Harmonic scalpel is a device that simultaneously cuts and coagulates soft tissues through ultrasonic vibrations. The aim of this study was to compare the results of Harmonic scalpel hemorrhoidectomy with conventional Milligan Morgan hemorrhoidectomy for the treatment of grade III and IV hemorrhoids.Methods: Patients with grade III or IV hemorrhoids, operated between January 2016 and December 2016, using the harmonic scalpel (n=30) or the conventional open technique (n=30) were studied. Both the groups were compared with respect to Operative time, Blood loss during surgery, early postoperative complications, postoperative pain measured on a visual analog scale (VAS), hospital stay, and return to normal work.Results: Harmonic scalpel and conventional open haemorrhoidectomy patients differ significantly in terms of VAS score of postoperative pain, blood loss during surgery, early post-operative complications, return to normal work. However, there is no significant difference in terms of duration of surgery and hospital stay in both the groups.Conclusions: Harmonic scalpel haemorrhoidectomy has been found advantageous method when assessing the amount of bleeding intraoperatively, post-operative pain, early postoperative complications, and Return to normal work. Hence Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternate method for treating symptomatic haemorrhoids.

scholarly journals Prospective randomised study using focus harmonic scalpel versus conventional hemostasis for vessel ligation in open thyroid surgery

2017 ◽  
Vol 4 (4) ◽  
pp. 1431 ◽  
Author(s):  
Anandaravi B. N. ◽  
Mohammed Anwar Aslam ◽  
Praveen P. Nair
Keyword(s):  
Hospital Stay ◽  
Total Thyroidectomy ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
P Value ◽  
Group V ◽  
Open Thyroidectomy ◽  
Randomised Study ◽  
Duration Of Hospital Stay ◽  
Prospective Randomised Study

Background: The objective was to compare operative factors, postoperative and surgical complications of open thyroidectomy by using FOCUS harmonic scalpel (HS) versus conventional hemostasis.Methods: A prospective randomised study in which 34 patients with benign/malignant thyroid disease patients underwent open thyroidectomy, patients were randomised into two groups, Group -1(HS) - included 19 patients which FOCUS Harmonic scalpel was used exclusively, Group -2(CH) included 15 patients in which conventional hemostasis was used exclusively. We recorded operative time, postoperative blood loss and drain output, postoperative complications and duration of hospital stay, patients were watched for 48-72 hours following surgery. The results were analysed by using student’s t-test.Results: Mean operative time for hemithyroidectomy was 53.40±9.07 minutes in HS group versus 85.25±17.03 minutes in CH group (p-value -0.004) mean operative in patients who underwent near total thyroidectomy is 67.21±10.36 in HS group v/s 109.60±29.35ml in CH group (p-value 0.001), postoperative drain output in patients who underwent hemithyroidectomy in HS group is 16.00±15.16 v/s 36.25±4.78 ml in CH group (p-value 0.008), postoperative drain output in patients who underwent near total thyroidectomy in HS group is 28.21±16.36ml v/s 45.50±8.95ml in CH group(p-value 0.006),length of hospital stay is 3.28±1.06 days in HS group v/s 4.20±1.39days in CH group,(p-value-0.083), complications like temporary hypocalcemia was present in 1 patient in HS group v/s 3 patients in CH group ,temporary RLN palsy was present in 2 patients in each group, there were no cases of permanent RLN palsy in either group, neither were the cases of permanent hypoparathyroidism in either group.Conclusions: FOCUS Harmonic scalpel will reduce operative time, reduces the incidence of symptomatic hypocalcemia but not temporary hypocalcemia,reduces postoperative drain output, reduces the duration of hospital stay, and shows no significance on incidence of temporary/permanent RLN palsy. FOCUS harmonic scalpel supposed to be more reliable and safe instrument that can be used instead of conventional hemostasis techniques in open thyroidectomy.

scholarly journals Comparison of Harmonic Scalpel versus conventional hemostasis in Thyroid surgery in terms of per-operative and postoperative outcome.

2020 ◽  
Vol 27 (01) ◽  
pp. 68-73
Author(s):  
Mumtaz Ali ◽  
Mudassar Murtaza ◽  
Mohammad Aleem-ud-Din ◽  
Mohammad Burhan Ud Din ◽  
Assam Sarwar ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Thyroid Surgery ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Laryngeal Nerve ◽  
P Value ◽  
Drainage Volume ◽  
Group A ◽  
The Mean ◽  
Group B

Harmonic scalpel is popular for use in a variety of surgical procedures including thyroid surgery. Proposed advantages of the harmonic scalpel include less lateral thermal tissue damage with no electrical energy transferred to the patient, no neuromuscular stimulation, less smoke formation as compared with electrocautery. Objectives: Our aim was to compare outcomes following thyroid surgery in terms of operative time, postoperative pain, drainage volume, recurrent laryngeal nerve and parathyroid gland injury with the use of the Harmonic Scalpel compared to conventional methods of hemostasis. Study Design: Randomized control trial. Setting: Surgical Department Lahore General Hospital. Period: Twelve Months June 2016 to June 2017. Material & Methods: 60 patients, 30 in each group. Patients were randomized in each group by balloting method. Operative time, postoperative pain and drainage volume was assessed during hospital stay. Recurrent laryngeal nerve and parathyroid gland injury was assessed during hospital stay and follow-up. Results: There was no significant difference in development of hoarseness of voice in both groups, p-value > 0.05. The mean operative time for group A was 69.47 ± 15.44 minutes and for group B it was 54.93 ± 11.56 minutes, p-value <0.05. The overall blood loss in group-A and group-B was 118.73 ± 50.72 ml and 44.60±10.70 ml, p-value<0.05. The mean post-op pain observed at 2nd day for group B was 2.93 ±3.57 and for group A it was 3.57±0.77, p-value < 0.05. Conclusion: Use of Harmonic Scalpel has better results in thyroid surgery in terms of less operative time, less postoperative pain, less drainage volume, while no RLN & parathyroid injury detected in either group.

Sign in / Sign up

Export Citation Format

Share Document