Thyroid surgery with the new harmonic scalpel: A prospective randomized study

Markogiannakis, Haridimos; Kekis, Panagiotis; Memos, Nikolaos; Alevizos, Leonidas; Tsamis, Dimitrios; Michalopoulos, Nikolaos V.; Lagoudianakis, Emmanuel; Toutouzas, Konstantinos G.; Manouras, Andreas

doi:10.1016/j.surg.2010.08.001

Cited by 30 publications

(18 citation statements)

References 34 publications

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“…Among the Harmonic instruments available, the CS-14-C® and the Ace® are the most frequently used for abdominal procedures. The Focus device was originally designed for head and neck surgery or breast surgery with axillary lymph node dissection [2,5]. However, in our opinion, the CS-14-C and Ace devices are cumbersome and are less ergonomic than the Focus shears, especially for the fine grasping and careful dissection required for resection in cancer of the pancreas head.…”

Section: Discussionmentioning

confidence: 99%

“…It offers significant benefits due to its small size, light weight, hand-activated trigger system and versatility. With superior properties to previous Harmonic devices, it enhances surgical efficiency by allowing precise dissection, grasping, coagulation and cutting without the need for numerous exchanges of surgical instruments and materials [2]. This report describes how we perform pancreaticoduodenectomy for pancreatic-head and periampullary cancer using Harmonic Focus, with particular reference to vascular and lymph node dissection.…”

Section: Introductionmentioning

confidence: 99%

“…Features include a curved, tapered, precise blade and an inactive Teflon clamp arm that provides protection for the underlying tissue. The instrument transects and seals vessels ≤5 mm as well as lymphatics ≤1 mm [2]. In pancreaticoduodenectomy, Harmonic Focus standard curved shears (9 cm shaft) are suitable for normal-weight patients whereas Harmonic Focus long shears (17 cm shaft) enable deep-access procedures in overweight patients.…”

Section: Introductionmentioning

confidence: 99%

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Pancreaticoduodenectomy with Harmonic Focust Curved Shears for Cancer

et al. 2014

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Ultrasonically activated shears enable the effective cutting and hemostasis of tissue, and have been shown to offer significant benefits in surgical procedures requiring fine dissection. Harmonic Focust, one of the latest ultrasonic devices, is a clip-like, light-weight, hand-held instrument with curved thin shears. Experience with Harmonic Focus in pancreatic surgery is limited. We have performed more than 1,000 pancreatic resections with this device. It may well represent a valuable tool for the extensive tissue and vascular dissection that is required in pancreaticoduodenectomy. In particular, Harmonic Focus performs very well in lymph node dissection, which is central in cancer surgery. In this report, we describe pancreaticoduodenectomy for pancreatic-head and periampullary cancer with the Harmonic Focus device. i 2014 S. Karger AG, Basel

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pancreaticoduodenectomy with Harmonic Focust Curved Shears for Cancer

et al. 2014

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“…The lateral thermal damage is limited to 0-2 mm beyond the tissue grasped and is less than that of bipolar or monopolar diathermy 13,14 . The last generation of the HS (Harmonic Focus) was implicated in this study which is even more appropriate since it is approved for closing vessels up to 5 mm in diameter 15 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of surgical outcomes of Ultrasonic technique (Harmonic Focus™) with Conventional technique in open hemithyroidectomy

Regmi

Bista

et al. 2014

J. Kathmandu Med. Coll.

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Background: The option for dissection and haemostasis during thyroid surgery include either the modern ultrasonic technology (Harmonic Focus™) or the conventional technique using knot and ties, monopolar or bipolar electrocautery. Comparison between the surgical outcomes of open hemithyroidectomy using these two modalities was done.Objective: To compare the surgical outcomes of ultrasonic technique using Harmonic Focus™ (HS) with Conventional technique (CT) in open hemithyoidectomy.Method: Twenty consecutive patients undergoing open hemithyroidectomy for benign solitary thyroid nodule of ≤ 3 cm were randomly assigned into two groups; group HS (n=10) and group CT (n=10). Analysis of surgical outcomes performed by these two techniques, particularly: operative time, intra-operative blood loss, post operative pain, incision size, complications and hospital stay were done.Results: The age, sex and pathologies were comparable in both the groups. For the group HS, mean operative time was (mean ± SD=55 ± 5 min) 15 minutes shorter than group CT (mean ± SD= 70 ± 10 min) (P<0.01). Mean operative blood loss was (mean ± SD=20 ±10 ml) 16 ml less in group HS than CT (mean ± SD= 36 ±12 ml) (P<0.01). The group HS experienced less post operative pain (mean ± SD=4 ± 0.94 VAS) than CT (mean ± SD= 7 ± 0.81 VAS) (P<0.001). The incision size at the time of skin closure was 1.6 cm shorter in group HS ((mean ± SD= 3.95 ±0.61 vs. 5.5 ± 0.78cm) (P<0.01). Hospital stay (mean ± SD= 2.30 ± 0.48 vs. 4.20 ±0.42 days) was statistically significant (P<0.01) in group HS than CT. There were no major complications.Conclusion: In patients undergoing open hemithyroidectomy, HS is a faster, better cosmetic, safe and less morbid tool than CT. Its use reduces operative time, blood loss, post operative pain, scar size, along with hospital stay.DOI: http://dx.doi.org/10.3126/jkmc.v2i4.11774 Journal of Kathmandu Medical CollegeVol. 2, No. 4, Issue 6, Oct.-Dec., 2013Page: 175-180

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“…It is usually divided into sharp and blunt dissection, distinguished as slicing tissues (sharp) and teasing tissues apart (blunt). Some surgeons would add a third type, energy or coagulating dissection, in which electric current or another source of heat is used to simultaneously coagulate and divide tissues (2)(3)(4)(5)(6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%