Bipolar Vessel Sealing System Versus Suture Ligation in Selective Neck Dissection

Abstract

Aim To evaluate whether the use of electrothermal bipolar vessel sealing system reduces the blood loss and operating time, with lesser complications as compared to suture ligation in selective neck dissection in patients with oral cancer. Materials and Methods The study was conducted in the Department of Oral and Maxillofacial Surgery of our institute from January 2015 to December 2016. The sample consisted of 60 patients, divided into Groups I and II with 30 subjects in each. In Group I electrothermal bipolar vessel sealer and in Group II suture ligation were used. The outcome measures recorded were: blood loss, operating time, quality of surgical field, postoperative pain on days 1, 2, and 3, drainage volume at 24, 48, and 72 h, edema, complications, and duration of hospital stay. Results There were 36 males and 24 females with a mean age of 50.76 ± 12.6 years. Blood loss was significantly less for Group I than for Group II (p = 0.001); the operating time was significantly less in Group I than in Group II (p = 0.001); Group I had better quality of surgical field (p = 0.001); less pain on postoperative evening, day 2 and day 3 (p \ 0.05); and less drainage volume at 24 and 48 h (p \ 0.05). Postoperative edema, complications, need for perioperative blood transfusion, and duration of hospital stay postsurgery were similar in both groups. Conclusion The electrothermal bipolar vessel sealer was efficacious in terms of reducing blood loss and operating time while providing a better surgical field and patient compliance without increasing the perioperative morbidity.

Total thyroidectomy: conventional suture ligation technique versus sutureless techniques

“…11 Sutureless thyroidectomy avoids leaving foreign bodies in the patient's body thus eliminating its complications, decreases the incidence of knot slippage, reduces the operative time by using one instrument in dissection, hemostasis, and cutting of tissues thus reducing patient's exposure to anesthesia, efficient in hemostasis decreasing intra-operative blood loss and safe, reducing postoperative drainage volume, provide a clean surgical field, and showed greater capability of grasping delicate tissues, 1,[11][12][13] provides precise and safer dissection near vital structures due to minimal lateral thermal tissue injury, a smaller incision can be used in thyroid surgery using HS, provides smoke-less surgery, no electrical energy to or through patient, less charring, desiccation, and tissue sticking and no neuromuscular stimulation when compared to electrocautery, increases the utility of the operating rooms, means that more patients can be managed, decreases post-operative use of analgesics in comparison to conventional technique, decreases the incidence of post-operative hypocalcemia, decreases the incidence of lymphorrea caused by dissection and ligations allowing shortening of the hospital stay, and decreases the costs collectively. [13][14][15][16][17][18][19] In the meantime, post-operative thyroid specimens excised by HS are easily evaluated histopathologically. 20 But it has its own disadvantages including the cost of device and availability limitations in some areas.…”