The use of FOCUS Harmonic scalpel compared to conventional haemostasis (knot and tie ligation) for thyroid surgery: a prospective randomized study

Haemostasis is crucial in thyroid surgery to avoid intraoperative and postoperative complications. In the presentstudy, we evaluated the efficiency and the safety of Harmonic scalpel when compared to conventional sutureligation in open total thyroidectomy. We enrolled 265 patients who underwent total thyroidectomy formultinodular disease since October 2011 up to October 2013. They were randomized into two groups: 141 in groupHS (Harmonic Scalpel), 124 in group CT (Conventional tecnique). We recorded the following data: operative time,post-operative blood loss, length of hospital stay and complications. The patients were monitored for 48 hours aftersurgery. Several differences were observed between the two groups (HS vs CT): the use of Harmonic scalpel wasassociated to a significant reduction of surgical operative time (110 min in CT vs 79.36 min in HS, p = 0.00001)and also associated to a lower blood loss (97.38 ml in CT vs 68.72 ml in HS, p = 0.00001). The length of stay wassignificantly shorter in the HS group (2.75 days in CT vs 1.93 days in HS) Complication rate was similar in thetwo groups. According to our experience, the Harmonic scalpel represents a safe alternative to conventionalhaemostasis in thyroid surgery, allowing for a significant reduction of operative time, blood loss andhospitalization. The rate of complication demonstrated no significant difference among the two groups.