Harmonic scalpel impact on blood loss and operating time in major head and neck surgery: a randomized clinical trial

Fritz, Dieter; Matthews, T. Wayne; Chandarana, Shamir; Nakoneshny, Steven C.; Dort, Joseph C.

doi:10.1186/s40463-016-0173-z

Cited by 13 publications

(17 citation statements)

References 21 publications

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“…It was 403 ml in the control group and 260ml in harmonic group(p = 0.08). 11 We found that overall blood loss in group A and group B was 118.73 ± 50.72 ml and 44.60±10.70 ml, p-value<0.05. In group-B intra, post op and overall group-B had low blood loss when compared to group-A, p-value < 0.001.…”

Section: Discussionmentioning

confidence: 65%

“…10 Use of harmonic scalpel can reduce the duration of operation by using its unique functions of coagulation and cutting at the same time. 11 initially it was used only in minimal invasive surgery but the device may prove its benefits in terms of reduced operative duration. It has also shown effectiveness in thyroid surgery outcomes, head and neck, chest and abdominal surgery.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Harmonic Scalpel versus conventional hemostasis in Thyroid surgery in terms of per-operative and postoperative outcome.

Ali

Murtaza

Aleemuddin³

et al. 2020

TPMJ

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Harmonic scalpel is popular for use in a variety of surgical procedures including thyroid surgery. Proposed advantages of the harmonic scalpel include less lateral thermal tissue damage with no electrical energy transferred to the patient, no neuromuscular stimulation, less smoke formation as compared with electrocautery. Objectives: Our aim was to compare outcomes following thyroid surgery in terms of operative time, postoperative pain, drainage volume, recurrent laryngeal nerve and parathyroid gland injury with the use of the Harmonic Scalpel compared to conventional methods of hemostasis. Study Design: Randomized control trial. Setting: Surgical Department Lahore General Hospital. Period: Twelve Months June 2016 to June 2017. Material & Methods: 60 patients, 30 in each group. Patients were randomized in each group by balloting method. Operative time, postoperative pain and drainage volume was assessed during hospital stay. Recurrent laryngeal nerve and parathyroid gland injury was assessed during hospital stay and follow-up. Results: There was no significant difference in development of hoarseness of voice in both groups, p-value > 0.05. The mean operative time for group A was 69.47 ± 15.44 minutes and for group B it was 54.93 ± 11.56 minutes, p-value <0.05. The overall blood loss in group-A and group-B was 118.73 ± 50.72 ml and 44.60±10.70 ml, p-value<0.05. The mean post-op pain observed at 2nd day for group B was 2.93 ±3.57 and for group A it was 3.57±0.77, p-value < 0.05. Conclusion: Use of Harmonic Scalpel has better results in thyroid surgery in terms of less operative time, less postoperative pain, less drainage volume, while no RLN & parathyroid injury detected in either group.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Comparison of Harmonic Scalpel versus conventional hemostasis in Thyroid surgery in terms of per-operative and postoperative outcome.

Ali

Murtaza

Aleemuddin³

et al. 2020

TPMJ

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“…Hematomas that form in enclosed spaces can expose the pedicle to constant pressure, resulting in flap morbidities. It has been accepted that harmonic scalpels effectively enable hemostasis, resulting in less intraoperative bleeding and postoperative hematoma formation (Aires et al, 2018;Fritz et al, 2016;Zhang et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Harmonic scalpels compared with electrocautery in reconstructive flap harvesting: A meta‐analysis

2021

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Background: Numerous studies have compared electrical devices used for flap surgery, but the results are inconsistent. This research was performed to evaluate the efficacy of two different types of electric devices: electrocautery and ultrasonic shears. Methods:The PubMed, Embase, and Scopus databases were searched systematically. A total of 505 cases were included in this study, including 209 electrocautery and 296 harmonic scalpel cases. The following information was retrieved from the included studies: the first author of the article, publication year, flap type, flap harvest time, drain volume, bleeding volume and postoperative complications. Hematoma, infection, flap necrosis and wound dehiscence were considered postoperative complications. The Q statistic for heterogeneity and the I 2 index were calculated. If I 2 < 50%, we used a fixed-effects model; if I 2 > 50%, we employed a random-effects model in our meta-analysis.Results: A total of eight studies which met the inclusion criteria were included and reviewed systematically for a meta-analysis. The harmonic scalpel yielded a statistically significantly more favorable flap harvest time and drain volume than did electrocautery. The Harmonic scalpel led to a shorter flap harvest time by 26.29 min (95% CI = À39.38 to À13.2; p < .00001) and smaller drain volume by 58.76 ml (95% CI = À105.27 to À12.25; p = .01) on average. However, there were no significant differences in the bleeding volume or incidence rates of infection, flap necrosis and wound dehiscence. Conclusion:The Harmonic scalpel method yields better outcomes in terms of the flap harvest time and drain volume than does the conventional electrocautery method.Therefore, the Harmonic scalpel is a better option for cauterization and dissection in flap surgery.

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“…Proper hemostatic control is critical intraoperatively to reduce blood loss, time of surgery, and, subsequently, postoperative morbidity and operative expenses. As mentioned before, conventional electrocautery is limited by excessive time for tissue dissection and wide thermal damage; which, in return, can result in excessive blood loss and prolonged operative time (20). The Ultrasonic shear works by dividing the tissues longitudinally through high-frequency ultrasonic waves, which takes potentially less time for tissue damage than conventional methods.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonic Shear Device versus Monopolar Electric Cautery in Conservative Breast Surgery Following Neoadjuvant Chemotherapy: A Comparative Study

Khaled¹,

Saad²,

Soliman³

et al. 2021

Preprint

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Background: Surgical devices are commonly used during breast-conservative surgery (BCS) to provide better hemostasis. Ultrasonic shear has recently gained momentum as an effective tool for intraoperative bleeding reduction. This comparative study was designed to determine the efficacy of Harmonic focus in reducing postoperative complications of BCS following neoadjuvant chemotherapy (CTH), in comparison to the conventional method using monopolar diathermy.Methods: We conducted a prospective, non-randomized, comparative, study on patients scheduled to undergo BCS with axillary dissection or sentinel lymph node biopsy after neoadjuvant CTH. Patients were recruited consecutively throughout the study period and were divided in an equal manner to undergo either monopolar electrocautery or Harmonic focus®.Results: Patients in the Harmonic Focus group had significantly shorter operative time than the monopolar electrocautery group (101.32 ± 27.3 versus 139.3 ± 31.9 minutes, respectively; p <0.001). Besides, the blood loss was significantly lower in the Harmonic Focus group (117.14 ± 35.6 versus 187 ± 49.8mL, respectively; p <0.001). Postoperatively, patients in the Harmonic Focus group had a significantly lower volume of chest wall drain (p <0.001) and shorter rime till drain removal (p <0.001). Likewise, patients in the Harmonic Focus group had a significantly lower volume of axillary drain and shorter rime till drain removal than monopolar electrocautery (p <0.001). The incidence of postoperative complications was comparable between both groups (p =0.128). Conclusions: In conclusion, the current study confirms the superiority of Harmonic Focus, compared to monopolar electrocautery, amongst patients receiving neoadjuvant CTH before BCS.

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Harmonic scalpel impact on blood loss and operating time in major head and neck surgery: a randomized clinical trial

Cited by 13 publications

References 21 publications

Comparison of Harmonic Scalpel versus conventional hemostasis in Thyroid surgery in terms of per-operative and postoperative outcome.

Comparison of Harmonic Scalpel versus conventional hemostasis in Thyroid surgery in terms of per-operative and postoperative outcome.

Harmonic scalpels compared with electrocautery in reconstructive flap harvesting: A meta‐analysis

Ultrasonic Shear Device versus Monopolar Electric Cautery in Conservative Breast Surgery Following Neoadjuvant Chemotherapy: A Comparative Study

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