Usefulness of Electrosurgical Techniques in Thyroid Gland Surgery

Abstract

Wide propagation of new generation of electrosurgical devices such as bipolar vessel sealing systems (eg. Thermostapler® by EMED) enabled seamless closing of blood vessels with a diameter up to 7 mm while maintaining the necessary safety margin, as well as reducing the duration of the operation. We decided to verify these reports in our material. Aim of the study was comparison of thyroid surgery performed with the electrocautery tool -Thermostapler® by EMED with surgery using classic hemostasis technique to evaluate the operative time and complications in the form of bleeding, recurrent laryngeal nerve paralysis, symptoms of hypoparathyroidism, and wound infection. Material and methods. We retrospectively analyzed 256 patients operated in the Department of General and Proctological Surgery Solec Hospital in Warsaw due to inert thyroid goitre. All patients underwent total thyroidectomy. Patients were divided into two groups. The first group consisted of 126 patients operated in 2000, using classic techniques of hemostasis. While the second group consisted of 130 patients operated in 2007-2008 with Thermostapler®. We compared duration of surgery and the incidence of postoperative complications. Results. The operative time was significantly shorter (average 18 minutes) in the second group of patients. We also recorded a statistically significant decrease in the incidence of complications in the group operated with Thermostapler. conclusions. Use of bipolar vessel sealing system in a decisive manner shortens the duration of operation. Use of bipolar vessel sealing system also enables a radical reduction in the incidence of complications rate such as bleeding, recurrent laryngeal nerve paralysis, symptoms of hypoparathyroidism, and wound infection. In the future, similar studies should be performed to assess the real costs resulting from the use Thermostapler®.

Incidence of and risk factors for surgical site infection following canine limb amputation

“…Despite this, the incidence of SSI does not appear to be increased with monopolar electrosurgery use compared to scalpel for midline celiotomy in dogs or people 13,15 . In 2 studies of people, use of a bipolar vessel sealing device was not associated with increased odds of SSI over standard techniques in thyroid surgery and axillary lymph node dissection 17,18 . As far as the authors are aware, no studies have been performed to specifically investigate bipolar vessel sealing device use for muscle transection.…”

“…13,15 In 2 studies of people, use of a bipolar vessel sealing device was not associated with increased odds of SSI over standard techniques in thyroid surgery and axillary lymph node dissection. 17,18 As far as the authors are aware, no studies have been performed to specifically investigate bipolar vessel sealing device use for muscle transection. In the present study, use of a bipolar vessel sealing device for muscle transection was associated with a 2.5 times increased odds of SSI across all procedures, 2.8 times increased odds of SSI for neoplastic cases only, and 2.6 times increased odds for clean cases only.…”