The Utility of the Harmonic Scalpel in Selective Neck Dissection

Walen, Scott; Rudmik, Luke; Dixon, Elijah; Matthews, T. Wayne; Nakoneshny, Steven C.; Dort, Joseph C.

doi:10.1177/0194599811403874

Cited by 23 publications

(38 citation statements)

References 15 publications

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“…Our group [16], and others, have demonstrated the HS to be an effective tool in reducing operative blood loss in neck dissection. In this study the addition of the oral cavity resection seems to minimize the impact of the HS.…”

Section: Discussionmentioning

confidence: 99%

“…The following protocol was adapted from our previous work with the HS in neck dissection [16]. All patients were operated on by 1 of 3 experienced head and neck oncologic surgeons (T.W.M., S.P.C., J.C.D.)…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies comparing the HS to standard techniques in selective neck dissection (SND) alone revealed a significant decrease in operative time, blood loss or both [16–20]. A recent randomized clinical trial from our group concluded that the HS is an effective tool for reducing blood loss in patients undergoing level I-IV neck dissection [16].…”

Section: Introductionmentioning

confidence: 95%

“…A recent randomized clinical trial from our group concluded that the HS is an effective tool for reducing blood loss in patients undergoing level I-IV neck dissection [16]. There are no randomized studies that measure the utility of the HS for oral resection combined with neck dissection.…”

Section: Introductionmentioning

confidence: 99%

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

Fritz

Matthews

Chandarana

et al. 2016

J of Otolaryngol - Head & Neck Surg

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BackgroundLong operating time and high blood loss contribute to post-surgical morbidity. Therefore, strategies to reduce these factors should to be tested using robust methods.The purpose of this study was to evaluate the impact of using the harmonic scalpel on operating time and blood loss in patients undergoing resection for advanced oral cancer (OSCC).MethodsThirty-six adult head and neck cancer patients with advanced OSCC requiring primary tumor resection with uni- or bi- lateral selective neck dissection from July 2012 to September 2014 were randomized to either the control group (traditional surgery) or the experimental group (harmonic surgery). Patients older than 18 years who were able to provide informed consent were eligible. Primary outcomes of interest were: intraoperative blood loss (mL) and operative time (minutes) for the ablative part of the surgery.ResultsMean blood loss in the experimental group was 260 mL versus 403 mL in the control group (p = 0.08). Mean operative time was 140 min in the experimental group and 159 min in the control group (p = 0.2).ConclusionsIn this randomized controlled trial, use of the harmonic scalpel did not effect intraoperative blood loss or OR time in patients undergoing surgery for advanced OSCC.Trial registrationClinicalTrials.gov, NCT02017834.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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

Fritz

Matthews

Chandarana

et al. 2016

J of Otolaryngol - Head & Neck Surg

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“…In 2009 Miccoli et al concluded that the HS during lateral lymphadenectomy (in patients with papillary thyroid cancer with neck metastases) is as safe as conventional technique and may allow shorter operative time, lower lymphatic spillage, and faster decrease of pain [25]. In 2011 Walen et al performed a prospective randomized controlled trial to determine the impact of the HS on intraoperative blood loss, and operative time in SND (levels I–IV) for HNSCC; they suggest that the HS can reduce blood loss during SND for HNSCC but it has no impact on operative time, postoperative drain output, or complication rate [26]. Recently, in 2012 Shin et al investigated the safety and the efficacy of HS in patients who underwent ND with primary HNSCC resection, demonstrating a significant reduction of operative time and blood loss in HS group [27].…”

Section: Discussionmentioning

confidence: 99%

Harmonic Scalpel versus Conventional Haemostasis in Neck Dissection: A Prospective Randomized Study

Ferri¹,

Armato

Spinato

et al. 2013

International Journal of Surgical Oncology

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Purpose. The aim of this prospective randomized trial was to compare operative factors, postoperative outcomes, and surgical complications of neck dissection (ND) when using the harmonic scalpel (HS) versus conventional haemostasis (CH) (classic technique of tying and knots, resorbable ligature, and bipolar diathermy). Materials and methods. Sixty-one patients who underwent ND with primary head and neck cancer (HNSCC) resection were enrolled in this study and were randomized into two homogeneous groups: CH (conventional haemostasis with classic technique of tying and knots, resorbable ligature, and bipolar diathermy) and HS (haemostasis with harmonic scalpel). Outcomes of the study included operative time, intraoperative blood loss, drainage volume, postoperative pain, hospital stay, and incidence of intraoperative and postoperative complications. Results. The use of the HS reduced significantly the operating time, the intraoperative blood loss, the postoperative pain, and the volume of drainage. No significant difference was observed in mean hospital stay and perioperative, and postoperative complications. Conclusion. The HS is a reliable and safe tool for reducing intraoperative blood loss, operative time, volume of drainage and postoperative pain in patients undergoing ND for HNSCC. Multicenter randomized studies need to be done to confirm the advantages of this technique and to evaluate the cost-benefit ratio.

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Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment

Bulsara

Worthington

Glenny

et al. 2018

Cochrane Database of Systematic Reviews

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The Utility of the Harmonic Scalpel in Selective Neck Dissection

Abstract: Results from this study suggest that the harmonic scalpel can reduce blood loss during SND for HNSCC. The harmonic scalpel had no impact on operative time, postoperative drain output, or complication rate.

Cited by 23 publications

References 15 publications

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

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

Harmonic Scalpel versus Conventional Haemostasis in Neck Dissection: A Prospective Randomized Study

Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment

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