Evaluation of the Ultrasonic Dissector in Thyroid Surgery. A Prospective Randomised Study

Deféchereux, Thierry; Rinken, F.; Maweja, Sylvie; Hamoir, Etienne; Meurisse, Michel

doi:10.1080/00015458.2003.11679422

Cited by 73 publications

(78 citation statements)

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“…Indeed, we found that robotic assistance was associated with significant differences in mean total SIS-6 scores and that a significantly lower percentage of patients reported swallowing discomfort at all postoperative time points, indicating that robot-assisted thyroidectomy can beneficially affect swallowing. This may be attributable to optical magnification of the operative field, to the precise handing possible using a flexible endoscopic instrument, and to a decrease in stress on the paraesophageal space with the use of the Harmonic scalpel [26,27].…”

Section: Discussionmentioning

confidence: 99%

Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy

et al. 2010

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Background Robotic thyroidectomy using a gasless transaxillary approach, first described in 2008, has become popular. This study compared outcomes, including postoperative distress and patient satisfaction, for patients undergoing robotic thyroidectomy with those for patients treated by conventional open thyroidectomy. Methods Of 84 prospectively enrolled patients, 41 underwent robotic thyroidectomy (the robot group), and 43 received conventional open thyroidectomy (the open group). All the patients were followed up for at least 3 months after surgery. Videolaryngostroboscopic examinations were performed preoperatively and after 1 week and after 3 months postoperatively. Postoperative pain and discomfort were evaluated using a symptom scale. Subjective voice and swallowing changes were assessed by questionnaires; and satisfaction with cosmetic outcome was measured by verbal response at 3 months. Results The two groups were similar in age, gender, type of operation, and final pathologic diagnosis. Although the mean operating time was significantly longer with the robotic technique than with open surgery, there were no betweengroup differences in postoperative pain or duration of hospital stay. No patient in either group experienced any major postoperative complication. Postoperative discomfort in the neck and swallowing disturbances were significantly more frequent in the open group than in the robot group, both at 1 week and at 3 months after surgery. However, there was no significant between-group difference in subjective voice parameters. At 3 months, the mean cosmetic satisfaction score was significantly higher in the robotic than in the open group. Conclusion Although postoperative pain levels and complications were comparable in the two groups, conventional open thyroidectomy requires a shorter operative time. The robotic technique, however, offers several distinct advantages including very good to excellent cosmetic results, reduced postoperative neck discomfort, and fewer adverse swallowing symptoms.Keywords Comparative study Á Cosmetic result Á Postoperative neck discomfort Á Robotic thyroidectomy Á Swallowing symptom Most patients with thyroid tumors are effectively treated surgically by practitioners experienced in the techniques of thyroidectomy. Many patients, especially women, undergoing thyroid surgery are concerned about the postoperative cosmetic appearance of the neck. Neck surgery also may result in postoperative discomfort, with pain, hyperesthesia, and paresthesia [1][2][3].

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Section: Discussionmentioning

confidence: 99%

Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy

et al. 2010

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“…Clips work for large vessels and are subject to dislodgment, whereas staples are wasted and costly for multiple single-vessel applications. Lasers are hindered by the risk of injury to many vital structures (e.g., recurrent nerves) in the operative field, and bipolar electrocautery does not give the surgeon the freedom of applicability at different angles [5].…”

Section: Discussionmentioning

confidence: 99%

Harmonic Scalpel Compared to Conventional Hemostasis in Thyroid Surgery

Yener¹,

Demır²,

Yılmaz³

et al. 2012

Indian J Surg

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The aim of this study was to determine whether conventional hemostasis (CH) or the harmonic scalpel (HS) results in shorter operative times for thyroidectomy and to evaluate the incidence of postoperative complications with each approach. In this study, 85 consecutive patients undergone open thyroidectomy were randomized into two groups: group CH (conventional hemostasis with classic technique of tying and knots, resorbable ligature, bipolar diathermy) and group HS (harmonic scalpel). Demographics, pathological characteristics, thyroid size, operative time, blood loss, and complications using the Student's t-test and χ 2 -test. The two groups were similar regarding age and sex. There were no intraoperative complications. There was no difference between the two techniques regarding the amount of blood loss for different procedures. No significant differences were found between the two groups concerning mean thyroid weight and mean hospital stay (2.2 days in HS vs. 3.7 in CH; P>0.05). The mean operative time was significantly shorter in the HS group (47.2 min vs. 79.2 min; P<0.001). Two (4.7 %) transient recurrent laryngeal nerve palsies were observed in the CH group and no one (0 %) in the HS group. No patient developed permanent palsy. Postoperative transient hypocalcemia occurred more frequently in the CH group (21/43, 48 % vs. 7/42, 16 %). 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.

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“…Tiroidektomide Harmonic Scalpel son yıllarda yaygın olarak kullanılmakta olup etkinliği ile ilgili bir çok çalışma yapılmıştır (3,4,6,7,(9)(10)(11)(12)(13)(14). Harmonic Scalpel'ın kolay kullanımı ve manipülasyonu, diseksiyon, kesme ve koagülas-yon işlemini aynı anda yapabilmesi nedeniyle operasyon süresini kısalttığı bildirilmiş ve bununda cihazın en önemli avantajı olduğu vurgulanmıştır (6,7,(15)(16)(17) (10,18,19,22).…”

Section: Discussionunclassified

“…Harmonic Scalpel'ın kolay kullanımı ve manipülasyonu, diseksiyon, kesme ve koagülas-yon işlemini aynı anda yapabilmesi nedeniyle operasyon süresini kısalttığı bildirilmiş ve bununda cihazın en önemli avantajı olduğu vurgulanmıştır (6,7,(15)(16)(17) (10,18,19,22). Çalışmamızda her iki grupta da kalıcı RLS hasarı gözlenmedi.…”

Section: Discussionunclassified

Is Harmonic Scalpel Beneficial in Total Thyroidectomy?

Özcan¹,

Mescı²,

Çolak³

et al. 2015

Akd Med J

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ÖZAmaç: Tiroidektomide konvansiyonel tekniğin (KT) yıllardır güvenle uygulandığı bilinmektedir. Ancak teknolojinin ilerlemesi tiroid cerrahisinde de değişikliklere yol açmaktadır. Harmonic Scalpel (HS), bu yeni teknolojik cihazlardan biri olup elektrik enerjisini ultrasonik enerjiye çevirerek uç kısmındaki bıçakların yüksek frekanslı titreşmesiyle çalışır. Koagülasyon ve kesme işleminin aynı anda yapılmasına olanak sağlayarak diseksiyon kolaylığı sağlar. Bu çalışmanın amacı, total tiroidektomilerde HS kullanı-mının KT göre bir avantaj sağlayıp sağlamadığını araştırmaktır. Gereç ve ABSTRACTObjective: The aim of this study was to investigate whether the use of the Harmonic Scalpel (HS) provides advantages in total thyroidectomy compared with the conventional technique (CT). Material and Methods:A total of 200 consecutive patients who underwent total thyroidectomy at the Department of General Surgery of the Akdeniz University Faculty of Medicine between 02.11.2009 and 21.07.2010 were included in the study. The patients were randomly divided into two groups. A total of 100 patients who underwent thyroidectomy using HS comprised the fi rst group and the remaining 100 patients who underwent thyroidectomy with the use of CT comprised the second group. The demographic data of the patients, operation and total anesthesia times, incision length, drainage amount, complication rate, and the FNAB (fi ne needle aspiration biopsy) and histopathology results of both groups were compared.Results: Operation and anesthesia times were found to be 16 minutes shorter in thyroidectomies performed using HS compared to the CT group (p<0.001). Transient and permanent nerve injuries, hypocalcemia and postoperative hemorrhage rates were not different between the groups. Conclusion:The operation time was found to have shortened without changes in thyroidectomyrelated complication rates using HS in total thyroidectomy. Thus, we believe that the use of the Harmonic Scalpel is an effective and safe method in thyroid surgery.

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Evaluation of the Ultrasonic Dissector in Thyroid Surgery. A Prospective Randomised Study

Cited by 73 publications

References 0 publications

Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy

Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy

Harmonic Scalpel Compared to Conventional Hemostasis in Thyroid Surgery

Is Harmonic Scalpel Beneficial in Total Thyroidectomy?

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