A Comparison of the LigaSure and Harmonic Scalpel in Thyroid Surgery: A Single Institution Review

Abstract

Background Over the last few years many surgeons have begun to utilize the LigaSure device or Harmonic scalpel to perform thyroid surgery. Several papers have demonstrated the benefits of these devices over traditional hand-tying techniques. The purpose of this study was to examine our institution’s experience with the LigaSure device and Harmonic scalpel during thyroid surgery and to compare mean operative times and complications associated with each device. Methods A retrospective chart review was performed on all patients who underwent thyroid surgery using either the LigaSure device or Harmonic scalpel at a single institution between December 2005 and August 2009. Charts were reviewed for patient demographics, mean operative time, length of stay, and complications such as transient recurrent laryngeal nerve injury, hypocalcemia, and hematoma formation. Results Two hundred and thirty-one patients were included in the study, of whom 123 underwent total thyroidectomy and 108 underwent lobectomy. There was a significant decrease in the operative time for both thyroidectomies and lobectomies when the Harmonic scalpel was utilized. In regard to complications, there was no statistically significant difference in the number of transient and permanent recurrent laryngeal nerve injuries, percentage of patients developing hypocalcemia, or in the rate of hematoma development. Conclusion In this study, there was no difference in the rate of complications between the two devices. However, the use of the Harmonic scalpel significantly decreased operative time for both thyroidectomies and thyroid lobectomies when compared to the LigaSure device.

A comparison of total thyroidectomies carried out through LigaSure and Harmonic Scalpel: a retrospective study

“…Olivier et al detected permanent hypocalcemia in 1 patient and transient hypocalcemia in 21 patients in their series of 100 patients that were operated on through LS in their study (21). Moreover, Zarebczan et al detected transient hypocalcemia in 12 patients in their series of 87 patients that were operated on through LS in their study (22). In contrast, Dionigi et al reported only 1 case of permanent hypocalcemia in 92 patients who underwent HS assisted total thyroidectomy (23).…”

Safety of energy based devices for hemostasis in thyroid surgery

“…Energy based devices (EBD) have been developed, implemented and increasingly applied in thyroid surgery because they can provide a combined dissection and haemostatic effect (6,7). In particular, advantages of EBD have been described in terms of efficacious haemostasis, reduction of procedure-associated time, reduced incision length, less operative blood loss and transfusion need, decreased postoperative drain, pain and hospital stay (6)(7)(8)(9)(10).…”

Infrared laser thermal fusion of blood vessels: preliminaryex vivotissue studies

“…Some RF-based devices provide electrical current to the vessel followed by an actuated mechanical knife which separates the coagulum into two sealed segments. These devices expedite normally labor-intensive surgical procedures such as lobectomy, 1,2 nephrectomy, 3 gastric bypass, 4-6 splenectomy, 7,8 thyroidectomy, [9][10][11][12][13][14] hysterectomy, 15 and colectomy. [16][17][18][19] However, both electrosurgical and ultrasonic devices have limitations, including the potential for undesirable charring and unnecessarily large collateral thermal damage zones.…”