Evaluation of the Harmonic Scalpel Use in the Surgical Treatment of Thyroid Diseases

The article presents the results of surgical treatment of patients with stages III to IV hemorrhoids followed by an observation period of 45 days, which is designed to improve the results of surgical treatment of this category of patients. The surgical treatment methods included doppler-guided transanal hemorrhoiddearterialization with mucopexy (DDM) (Group I) and harmonic scalpel hemorrhoidectomy (HSH) (Group II). Operated patients underwent all necessary examinations according to the “per protocol” principle. Study Design: single-center controlled randomized prospective. The effectiveness of DDM was comparable to that of hemorrhoidectomy (HE), which made it possible to significantly reduce the duration of the operation (DDM 17.9 ± 6.1 min, GE 34.5 ± 10.1 min (p <0.01) ), reduce the level of pain in the postoperative period (DDM an average of 2.5 points, HE 4.8 points (p <0.01)), reduce the frequency of narcotic analgesics (DDM an average of 1.3 doses, HE an average of 6.1 doses (p <0.01)) and shorten the period of disability (DDM 14.4 ± 5.2 days, HE 30.3 ± 5.4 days (p <0.01)) patients with stages III to IV disease.

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Summary Survey of the Surgical Treatment for Thyroid Diseases

JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY ◽

10.5106/jjshns.8.125 ◽

1998 ◽

Vol 8 (2) ◽

pp. 125-129

Author(s):

Hirobumi Kumazawai ◽

Takuya Tachikawa ◽

Hisaya Yukawa ◽

Toshihiko Kaneko ◽

Toshio Yamashita ◽

...

Keyword(s):

Surgical Treatment ◽

Thyroid Diseases

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Thyroid morphology and function after surgical treatment of thyroid diseases

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-0029-1211453 ◽

2009 ◽

Vol 104 (03) ◽

pp. 271-277 ◽

Cited By ~ 11

Author(s):

B. Mann ◽

P. Schmale ◽

W. Stremmel

Keyword(s):

Surgical Treatment ◽

Thyroid Diseases ◽

Thyroid Morphology ◽

And Function

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MODERN SURGICAL INTERVENTIONS IN PATIENTS WITH THYROID DISEASES

Vestnik of Russian military medical Academy ◽

10.17816/brmma13048 ◽

2019 ◽

Vol 21 (1) ◽

pp. 69-72

Author(s):

D D Dolidze ◽

A V Shabunin ◽

R B Mumladze ◽

A V Vardanyan ◽

I N Lebedinskiy ◽

...

Keyword(s):

Surgical Treatment ◽

Stress Test ◽

Thyroid Diseases ◽

Endocrine Surgery ◽

Surgical Interventions ◽

Postoperative Hypoparathyroidism ◽

Operative Complications ◽

Cosmetic Effect ◽

Methodological Approaches ◽

Group Ii

The study is based on the analysis of the results of surgical treatment of 298 patients with various diseases of the thyroid gland, who were examined and treated in the department of endocrine surgery of the City Clinical Hospital named after S. P. Botkin from 2012 to 2016. 147 (49.3%) patients of the I group were operated on using extrafascial technique with intersection of the prelaryngeal muscles and visualization of the recurrent laryngeal nerve. 151 (51.7%) patients of group II underwent extrafascial surgical interventions from reduced migratory approaches using modern, including original, methodological approaches. For the prevention of paresis of the larynx in the allocation of recurrent laryngeal nerves, microsurgical instruments and magnifying devices were used. For the prevention of postoperative hypoparathyroidism, in addition to carefully accounting for anatomical and topographic-anatomical features, a «stress-test» and a method of double visual-instrumental recording of the parathyroid gland-induced fluorescence were used. In the first group of patients with surgical treatment, the following complications were recorded: in 2 (1.4%) patients developed permanent, in 8 (5.4%) transient postoperative hypoparathyroidism, and in 3 (2.0%) - temporary unilateral laryngeal paresis. The overall incidence of operative complications was 8.8% (13 patients). In the postoperative period, the following complications were recorded in group II: 2 (1.3%) patients developed transient hypocalcemia, and 1 (0.7%) patient had unilateral laryngeal paresis. The overall incidence of operative complications was 1.99% (3 patients). Analysis of the cosmetic result of the intervention, assessed on the POSAS scale, showed that cosmetic effect was better in group II (p 0.05). Thus, modern surgical interventions in patients with thyroid diseases, including new methodological approaches, have improved the results of surgical treatment with a decrease of the number of complications and achieving a better cosmetic effect of the surgical intervention.

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The first experience of laser spectroscopy in the surgical treatment of thyroid diseases

Problems of Endocrinology ◽

10.14341/probl11694 ◽

2019 ◽

Vol 45 (1) ◽

pp. 17-20

Author(s):

P. S. Vetshev ◽

K. E. Chilingaridi ◽

L. I. Ippolitov ◽

S. S. Harnas ◽

V. B. Loshchenov ◽

...

Keyword(s):

Thyroid Cancer ◽

Surgical Treatment ◽

Laser Spectroscopy ◽

Histological Analysis ◽

Follicle Cell ◽

Rapid Diagnosis ◽

Thyroid Diseases ◽

Subtotal Resection ◽

Intraoperative Rapid Diagnosis

For assessing the efficacy of intraoperative laser autofluorescent spectroscopy (IOLAS), 46 patients with thyroid diseases of different etiology are examined. The patients ’ aged varied from 30 to 65 years. The following morphological types of diseases were observed: benign nodular formations in 42 patients, thyroid cancer in 4, papillary TINO MO in 2, and follicular cancer TINO MO in 2 cases. Out of benign formations, 36 were multinodular colloid goiter and 6 follicle-cell adenomas. As a result of using IOLAS, thyroid cancer was diagnosed during surgery in 8 (17.4%) out of 36 patients with multinodular colloid goiter; this diagnosis necessitated more extensive intervention than was planned: subtotal resection had to be extended to thyroidectomy. In all the cases IOLAS data were confirmed by urgent and later planned histological analyses. Due to this method, no reoperations were needed, which previously had to be performed because of the data of planned histological analysis, and therefore, the probable complications of reoperations were prevented. Our data indicate that IOLAS more accurately identifies the type and morphology of thyroid involvement and helps choose adequate volume of intervention. The first experience with laser fluorescent study as optic biopsy holds good promise as regards improvement of intraoperative rapid diagnosis of thyroid diseases.

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Harmonic scalpel® hemorrhoidectomy: A painless procedure?

Medicinski pregled ◽

10.2298/mpns0710421i ◽

2007 ◽

Vol 60 (9-10) ◽

pp. 421-426 ◽

Cited By ~ 8

Author(s):

Dejan Ivanov ◽

Sinisa Babovic ◽

Dora Selesi ◽

Mirjana Ivanov ◽

Radovan Cvijanovic

Keyword(s):

Surgical Treatment ◽

Postoperative Pain ◽

Visual Analog Scale ◽

Surgical Approach ◽

Surgical Procedure ◽

Thermal Damage ◽

Harmonic Scalpel ◽

Hemorrhoidal Disease ◽

Disease Stage ◽

Analog Scale

Since the surgical treatment of hemorrhoidal disease has been characterized by intense postoperative pain, recent studies have tried to modify the standard Milligan-Morgans technique. The up-to-date literature, in the experience of authors, has confirmed that the new method of Harmonic Scalpel? hemorrhoidectomy reduces postoperative pain. The aim of our study was to statistically evaluate, based on our experience, the efficacy of this surgical approach in terms of reducing postoperative pain and establishing a stable hemostasis. Seventy-seven (77) patients suffering from hemorrhoid disease, stage III and IV, underwent surgery in our clinic during the last five years. The postoperative pain was determined using the visual analog scale on the 1st, 2nd and 7th postoperative days. Patients were divided into two groups in regard to the surgical procedure applied. The data were statistically processed using the Statistica 7.0 software. We concluded that Harmonic Scalpel? hemorrhoidectomy, due to less thermal damage, statistically significantly reduced postoperative pain with better hemostasis, compared with Milligan-Morgan's method of treating hemorrhoidal disease. .

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Cervicofacial Cavernous Venous Malformation With Massive Macroglossia: Novel Surgical Treatment With Harmonic Scalpel

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2009.09.010 ◽

2010 ◽

Vol 68 (2) ◽

pp. 475-479 ◽

Cited By ~ 3

Author(s):

Paul V. Joseph ◽

Vinod B. Nair

Keyword(s):

Surgical Treatment ◽

Harmonic Scalpel ◽

Venous Malformation

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Laparoscopic Repair of Congenital Diaphragmatic Hernia in Adults

Minimally Invasive Surgery ◽

10.1155/2016/9032380 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Sanjay Kumar Saroj ◽

Satendra Kumar ◽

Yusuf Afaque ◽

Abhishek Kumar Bhartia ◽

Vishnu Kumar Bhartia

Keyword(s):

Surgical Treatment ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Laparoscopic Repair ◽

Harmonic Scalpel ◽

Postoperative Recovery ◽

Early Recovery ◽

Asymptomatic Patients ◽

The Right

Background, Aims, and Objectives. Congenital diaphragmatic hernia typically presents in childhood but in adults is extremely rare entity. Surgery is indicated for symptomatic and asymptomatic patients who are fit for surgery. It can be done by laparotomy, thoracotomy, thoracoscopy, or laparoscopy. With the advent of minimal access techniques, the open surgical repair for this hernia has decreased and results are comparable with early recovery and less hospital stay. The aim of this study is to establish that laparoscopic repair of congenital diaphragmatic hernia is a safe and effective modality of surgical treatment.Materials and Methods.A retrospective study of laparoscopic diaphragmatic hernia repair done during May 2011 to Oct 2014. Totaln=13(M/F: 11/2) cases of confirmed diaphragmatic hernia on CT scan, 4 cases Bochdalek hernia (BH), 8 cases of left eventration of the diaphragm (ED), and one case of right-sided eventration of the diaphragm (ED) were included in the study. Largest defect found on the left side was 15 × 6 cm and on the right side it was 15 × 8 cm. Stomach, small intestine, transverse colon, and omentum were contents in the hernial sac. The contents were reduced with harmonic scalpel and thin sacs were usually excised. The eventration was plicated and hernial orifices were repaired with interrupted horizontal mattress sutures buttressed by Teflon pieces. A composite mesh was fixed with nonabsorbable tackers. All patients had good postoperative recovery and went home early with normal follow-up and were followed up for 2 years.Conclusion.The laparoscopic repair is a safe and effective modality of surgical treatment for congenital diaphragmatic hernia in experienced hands.

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