Randomized Comparative Study between Ligasure Vessel Sealing System, Harmonic Scalpel, and Conventional Suture Ligation Technique to Achieve Hemostasis in Thyroidectomy for Toxic Goitre

Abstract

Thyroid surgery involves meticulous devascularization of the thyroid gland which has one of the richest blood supplies among the organs, with numerous blood vessels and plexuses entering its parenchyma. Therefore, hemostasis is of paramount importance to control and divide various vessels before excision of the gland. This study was done to compare of the outcomes of total thyroidectomy operations with the Harmonic Focus &Ligasure vessel sealing system in comparison to the conventional haemostasis. Our study included 45 patients (diagnosed to have controlled 2ry toxic goiter or uncontrolled 1ry toxic goiter), who were divided to three groups. Group (1) include 15 patients who undergone total thyroidectomy with conventional haemostasis and group (2) include15 patients who undergone total thyroidectomy with ligasure vessel sealing system, and group (3) include15 patients who undergone total thyroidectomy with harmonic focus scalpel. We compared between three groups according to operative time, post-operative complications (as RLN injury and hypocalcemia), post-operative pain, blood drainage, hospital stays and hospital cost. According to our study there was significant difference between the Harmonic Focus Scalpel, ligasure sealing system and the conventional haemostasis as regarding to operative time (Harmonic Focus&ligasure take short time thanConventional Hemostatic ), post-operative pain (pain less severe with Harmonic Focus&ligasure thanConventional Hemostatic ), post-operative blood drainage (using of the Harmonic Focus&ligasure leads to decrease post-operative blood drainage than theConventional Hemostatic ), and hospital stays (using of the Harmonic Focus&ligasure leads to short hospital stays than theConventional Hemostatic ). However their was no significant difference between the three groups in relations to post-operative complications (as the RLN injury and hypocalcemia).