Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2011

Open Access 01-12-2011 | Technical innovations

Harmonic focus in total thyroidectomy plus level III-IV and VI dissection: a prospective randomized study

Authors: Qingqing He, Dayong Zhuang, Luming Zheng, Peng Zhou, Jixin Chai, Zhen Lv

Published in: World Journal of Surgical Oncology | Issue 1/2011

Login to get access

Abstract

The aim of this study was to compare operating time, postoperative outcomes, and surgical complications of total thyroidectomy plus level III-IV and VI dissection between the no-tie technique using the Harmonic Focus and classic suture ligation for hemostasis. Fifty-four patients underwent total thyroidectomy plus level III-IV and VI dissection by classic suture ligation and 51 patients by the Harmonic Focus. There was obvious distinction as to the operating time between the Focus and classic group (102.8 and 150.1 minutes, respectively, P < 0.05). Drainage volume (202.7 ± 187.0 mL vs 299.7 ± 201.4 mL, P < 0.05) were significantly lower in the Focus group. Transient hypoparathyroidism had no statistically significant difference between the groups (17.6% vs 18.5%, P > 0 .05). No patient experienced nerve injury or permanent hypocalcemia. The use of Harmonic Focus for the control of thyroid vessels during thyroid surgery is reliable and safe. The device can offer extraordinary capabilities for delicate tissue grasping and dissection.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bandi G, Wen CC, Wilkinson EA, Hedican SP, Moon TD, Nakada SY: Comparison of blade temperature dynamics after activation of Harmonic Ace scalpel and the Ultracision Harmonic Scalpel LCS-K5. J Endourol. 2008, 22: 333-336. 10.1089/end.2007.0169.CrossRefPubMed Bandi G, Wen CC, Wilkinson EA, Hedican SP, Moon TD, Nakada SY: Comparison of blade temperature dynamics after activation of Harmonic Ace scalpel and the Ultracision Harmonic Scalpel LCS-K5. J Endourol. 2008, 22: 333-336. 10.1089/end.2007.0169.CrossRefPubMed
2.
go back to reference Redwan AA: Single-working-instrument, double-trocar, clipless cholecystectomy using harmonic scalpel: a feasible, safe, and less invasive technique. J Laparoendosc Adv Surg Tech A. 2010, 20: 597-603. 10.1089/lap.2009.0375.CrossRefPubMed Redwan AA: Single-working-instrument, double-trocar, clipless cholecystectomy using harmonic scalpel: a feasible, safe, and less invasive technique. J Laparoendosc Adv Surg Tech A. 2010, 20: 597-603. 10.1089/lap.2009.0375.CrossRefPubMed
3.
go back to reference Wilhelm T, Metzig A: Endoscopic minimally invasive thyroidectomy: first clinical experience. Surg Endosc. 2010, 24: 1757-1758. 10.1007/s00464-009-0820-9.CrossRefPubMed Wilhelm T, Metzig A: Endoscopic minimally invasive thyroidectomy: first clinical experience. Surg Endosc. 2010, 24: 1757-1758. 10.1007/s00464-009-0820-9.CrossRefPubMed
4.
go back to reference Ecker T, Carvalho AL, Choe JH, Walosek G, Preuss KJ, Hemostasis in thyroid surgery: harmonic scalpel versus other techniques--a meta-analysis. Otolaryngol Head Neck Surg. 2010, 143: 17-25.CrossRefPubMed Ecker T, Carvalho AL, Choe JH, Walosek G, Preuss KJ, Hemostasis in thyroid surgery: harmonic scalpel versus other techniques--a meta-analysis. Otolaryngol Head Neck Surg. 2010, 143: 17-25.CrossRefPubMed
5.
go back to reference Sanguinetti A, Docimo G, Ragusa M, Calzolari F, D'Ajello F, Ruggiero R, Parmeggiani D, Pezzolla A, Procaccini E, Avenia N: Ultrasound scissors versus electrocautery in axillary dissection: our experience. G Chir. 2010, 31: 151-153.PubMed Sanguinetti A, Docimo G, Ragusa M, Calzolari F, D'Ajello F, Ruggiero R, Parmeggiani D, Pezzolla A, Procaccini E, Avenia N: Ultrasound scissors versus electrocautery in axillary dissection: our experience. G Chir. 2010, 31: 151-153.PubMed
6.
go back to reference Robbins KT, Shaha AR, Medina JE, Califano JA, Wolf GT, Ferlito A, Som PM, Day TA, Committee for Neck Dissection Classification, American Head and Neck Society: Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg. 2008, 134: 536-538. 10.1001/archotol.134.5.536.CrossRefPubMed Robbins KT, Shaha AR, Medina JE, Califano JA, Wolf GT, Ferlito A, Som PM, Day TA, Committee for Neck Dissection Classification, American Head and Neck Society: Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg. 2008, 134: 536-538. 10.1001/archotol.134.5.536.CrossRefPubMed
7.
go back to reference Yu XM, Wan Y, Sippel RS, Chen H: Should all papillary thyroid microcarcinomas be aggressively treated? an analysis of 18,445 cases. Ann Surg. 2011, 254: 653-660.CrossRefPubMed Yu XM, Wan Y, Sippel RS, Chen H: Should all papillary thyroid microcarcinomas be aggressively treated? an analysis of 18,445 cases. Ann Surg. 2011, 254: 653-660.CrossRefPubMed
8.
go back to reference Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A: AJCC cancer staging manual (7th ed). 2010, New York, NY: Springer, 111-122. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A: AJCC cancer staging manual (7th ed). 2010, New York, NY: Springer, 111-122.
9.
go back to reference Dadan J, Nowacka A: A journey into the past--the history of thyroid surgery. Wiad Lek. 2008, 61: 88-92.PubMed Dadan J, Nowacka A: A journey into the past--the history of thyroid surgery. Wiad Lek. 2008, 61: 88-92.PubMed
10.
go back to reference Pons Y, Gauthier J, Ukkola-Pons E, Clément P, Roguet E, Poncet JL, Conessa C: Comparison of LigaSure vessel sealing system, harmonic scalpel, and conventional hemostasis in total thyroidectomy. Otolaryngol Head Neck Surg. 2009, 141: 496-501. 10.1016/j.otohns.2009.06.745.CrossRefPubMed Pons Y, Gauthier J, Ukkola-Pons E, Clément P, Roguet E, Poncet JL, Conessa C: Comparison of LigaSure vessel sealing system, harmonic scalpel, and conventional hemostasis in total thyroidectomy. Otolaryngol Head Neck Surg. 2009, 141: 496-501. 10.1016/j.otohns.2009.06.745.CrossRefPubMed
11.
go back to reference Lombardi CP, Raffaelli M, Cicchetti A, Marchetti M, De Crea C, Di Bidino R, Oragano L, Bellantone R: The use of "harmonic scalpel" versus "knot tying" for conventional "open" thyroidectomy: results of a prospective randomized study. Langenbecks Arch Surg. 2008, 393: 627-631. 10.1007/s00423-008-0380-9.CrossRefPubMed Lombardi CP, Raffaelli M, Cicchetti A, Marchetti M, De Crea C, Di Bidino R, Oragano L, Bellantone R: The use of "harmonic scalpel" versus "knot tying" for conventional "open" thyroidectomy: results of a prospective randomized study. Langenbecks Arch Surg. 2008, 393: 627-631. 10.1007/s00423-008-0380-9.CrossRefPubMed
12.
go back to reference Prgomet D, Janjanin S, Bilić M, Prstacić R, Kovac L, Rudes M, Katić V: A prospective observational study of 363 cases operated with three different harmonic scalpels. Eur Arch Otorhinolaryngol. 2009, 266: 1965-1970. 10.1007/s00405-009-0954-3.CrossRefPubMed Prgomet D, Janjanin S, Bilić M, Prstacić R, Kovac L, Rudes M, Katić V: A prospective observational study of 363 cases operated with three different harmonic scalpels. Eur Arch Otorhinolaryngol. 2009, 266: 1965-1970. 10.1007/s00405-009-0954-3.CrossRefPubMed
13.
go back to reference Markogiannakis H, Kekis PB, Memos N, Alevizos L, Tsamis D, Michalopoulos NV, Lagoudianakis EE, Toutouzas KG, Manouras A: Thyroid surgery with the new harmonic scalpel: A prospective randomized study. Surgery. 2011, 149: 411-415. 10.1016/j.surg.2010.08.001.CrossRefPubMed Markogiannakis H, Kekis PB, Memos N, Alevizos L, Tsamis D, Michalopoulos NV, Lagoudianakis EE, Toutouzas KG, Manouras A: Thyroid surgery with the new harmonic scalpel: A prospective randomized study. Surgery. 2011, 149: 411-415. 10.1016/j.surg.2010.08.001.CrossRefPubMed
14.
go back to reference Manouras A, Markogiannakis HE, Kekis PB, Lagoudianakis EE, Fleming B: Novel hemostatic devices in thyroid surgery: electrothermal bipolar vessel sealing system and harmonic scalpel. Expert Rev Med Devices. 2008, 5: 447-466. 10.1586/17434440.5.4.447.CrossRefPubMed Manouras A, Markogiannakis HE, Kekis PB, Lagoudianakis EE, Fleming B: Novel hemostatic devices in thyroid surgery: electrothermal bipolar vessel sealing system and harmonic scalpel. Expert Rev Med Devices. 2008, 5: 447-466. 10.1586/17434440.5.4.447.CrossRefPubMed
15.
go back to reference Koh YW, Park JH, Kim JW, Lee SW, Choi EC: Clipless and sutureless endoscopic thyroidectomy using only the harmonic scalpel. Surg Endosc. 2010, 24: 1117-1125. 10.1007/s00464-009-0738-2.CrossRefPubMed Koh YW, Park JH, Kim JW, Lee SW, Choi EC: Clipless and sutureless endoscopic thyroidectomy using only the harmonic scalpel. Surg Endosc. 2010, 24: 1117-1125. 10.1007/s00464-009-0738-2.CrossRefPubMed
16.
go back to reference Cirocchi R, D'Ajello F, Trastulli S, Santoro A, Di Rocco G, Vendettuoli D, Rondelli F, Giannotti D, Sanguinetti A, Minelli L, Redler A, Basoli A, Avenia N: Meta-analysis of thyroidectomy with ultrasonic dissector versus conventional clamp and tie. World Journal of Surgical Oncology. 2010, 8: 112-128. 10.1186/1477-7819-8-112.PubMedCentralCrossRefPubMed Cirocchi R, D'Ajello F, Trastulli S, Santoro A, Di Rocco G, Vendettuoli D, Rondelli F, Giannotti D, Sanguinetti A, Minelli L, Redler A, Basoli A, Avenia N: Meta-analysis of thyroidectomy with ultrasonic dissector versus conventional clamp and tie. World Journal of Surgical Oncology. 2010, 8: 112-128. 10.1186/1477-7819-8-112.PubMedCentralCrossRefPubMed
17.
go back to reference Miccoli P, Materazzi G, Miccoli M, Frustaci G, Fosso A, Berti P: Evaluation of a new ultrasonic device in thyroid surgery: comparative randomized study. Am J Surg. 2010, 199: 736-740. 10.1016/j.amjsurg.2009.04.003.CrossRefPubMed Miccoli P, Materazzi G, Miccoli M, Frustaci G, Fosso A, Berti P: Evaluation of a new ultrasonic device in thyroid surgery: comparative randomized study. Am J Surg. 2010, 199: 736-740. 10.1016/j.amjsurg.2009.04.003.CrossRefPubMed
18.
go back to reference Miccoli P, Materazzi G, Berti P: Minimally invasive thyroidectomy in the treatment of well differentiated thyroid cancers: indications and limits. Curr Opin Otolaryngol Head Neck Surg. 2010, 18: 114-118. 10.1097/MOO.0b013e3283378239.CrossRefPubMed Miccoli P, Materazzi G, Berti P: Minimally invasive thyroidectomy in the treatment of well differentiated thyroid cancers: indications and limits. Curr Opin Otolaryngol Head Neck Surg. 2010, 18: 114-118. 10.1097/MOO.0b013e3283378239.CrossRefPubMed
19.
go back to reference McNally MM, Agle SC, Williams RF, Pofahl WE: A comparison of two methods of hemostasis in thyroidectomy. Am Surg. 2009, 75: 1073-1076.PubMed McNally MM, Agle SC, Williams RF, Pofahl WE: A comparison of two methods of hemostasis in thyroidectomy. Am Surg. 2009, 75: 1073-1076.PubMed
20.
go back to reference Koh YW, Park JH, Lee SW, Choi EC: The harmonic scalpel technique without supplementary ligation in total thyroidectomy with central neck dissection: a prospective randomized study. Ann Surg. 2008, 247: 945-949. 10.1097/SLA.0b013e31816bcd61.CrossRefPubMed Koh YW, Park JH, Lee SW, Choi EC: The harmonic scalpel technique without supplementary ligation in total thyroidectomy with central neck dissection: a prospective randomized study. Ann Surg. 2008, 247: 945-949. 10.1097/SLA.0b013e31816bcd61.CrossRefPubMed
21.
go back to reference Barczyński M, Konturek A, Cichoń S: Minimally invasive video-assisted thyreoidectomy (MIVAT) with and without use of harmonic scalpel--a randomized study. Langenbecks Arch Surg. 2008, 393: 647-654. 10.1007/s00423-008-0373-8.CrossRefPubMed Barczyński M, Konturek A, Cichoń S: Minimally invasive video-assisted thyreoidectomy (MIVAT) with and without use of harmonic scalpel--a randomized study. Langenbecks Arch Surg. 2008, 393: 647-654. 10.1007/s00423-008-0373-8.CrossRefPubMed
22.
go back to reference Sartori PV, De Fina S, Colombo G, Pugliese F, Romano F, Cesana G, Uggeri F: Ligasure versus Ultracision in thyroid surgery: a prospective randomized study. Langenbecks Arch Surg. 2008, 393: 655-658. 10.1007/s00423-008-0386-3.CrossRefPubMed Sartori PV, De Fina S, Colombo G, Pugliese F, Romano F, Cesana G, Uggeri F: Ligasure versus Ultracision in thyroid surgery: a prospective randomized study. Langenbecks Arch Surg. 2008, 393: 655-658. 10.1007/s00423-008-0386-3.CrossRefPubMed
23.
go back to reference Mourad M, Rulli F, Robert A, Scholtes JL, De Meyer M, De Pauw L: Randomized clinical trial on Harmonic Focus shears versus clamp-and-tie technique for total thyroidectomy. Am J Surg. 2011, 202: 168-174. 10.1016/j.amjsurg.2010.07.047.CrossRefPubMed Mourad M, Rulli F, Robert A, Scholtes JL, De Meyer M, De Pauw L: Randomized clinical trial on Harmonic Focus shears versus clamp-and-tie technique for total thyroidectomy. Am J Surg. 2011, 202: 168-174. 10.1016/j.amjsurg.2010.07.047.CrossRefPubMed
24.
go back to reference Nakayama H, Ito H, Kato Y, Tsuboi M: Ultrasonic scalpel for sealing of the thoracic duct: evaluation of effectiveness in an animal model. Interact Cardiovasc Thorac Surg. 2009, 9: 399-401. 10.1510/icvts.2009.206706.CrossRefPubMed Nakayama H, Ito H, Kato Y, Tsuboi M: Ultrasonic scalpel for sealing of the thoracic duct: evaluation of effectiveness in an animal model. Interact Cardiovasc Thorac Surg. 2009, 9: 399-401. 10.1510/icvts.2009.206706.CrossRefPubMed
25.
go back to reference Sebag F, Fortanier C, Ippolito G, Lagier A, Auquier P, Henry JF: Harmonic scalpel in multinodular goiter surgery: impact on surgery and cost analysis. J Laparoendosc Adv Surg Tech A. 2009, 19: 171-174. 10.1089/lap.2008.0043.CrossRefPubMed Sebag F, Fortanier C, Ippolito G, Lagier A, Auquier P, Henry JF: Harmonic scalpel in multinodular goiter surgery: impact on surgery and cost analysis. J Laparoendosc Adv Surg Tech A. 2009, 19: 171-174. 10.1089/lap.2008.0043.CrossRefPubMed
26.
go back to reference D'Ajello F, Cirocchi R, Docimo G, Catania A, Ardito G, Rosato L, Avenia N: Thyroidectomy with ultrasonic dissector: a multicentric experience. G Chir. 2010, 31: 289-292.PubMed D'Ajello F, Cirocchi R, Docimo G, Catania A, Ardito G, Rosato L, Avenia N: Thyroidectomy with ultrasonic dissector: a multicentric experience. G Chir. 2010, 31: 289-292.PubMed
27.
go back to reference Scilletta B, Cavallaro MP, Ferlito F, Li Destri G, Minutolo V, Frezza EE, Di Cataldo A: Thyroid surgery without cut and tie: the use of Ligasure for total thyroidectomy. Int Surg. 2010, 95: 293-298.PubMed Scilletta B, Cavallaro MP, Ferlito F, Li Destri G, Minutolo V, Frezza EE, Di Cataldo A: Thyroid surgery without cut and tie: the use of Ligasure for total thyroidectomy. Int Surg. 2010, 95: 293-298.PubMed
Metadata
Title
Harmonic focus in total thyroidectomy plus level III-IV and VI dissection: a prospective randomized study
Authors
Qingqing He
Dayong Zhuang
Luming Zheng
Peng Zhou
Jixin Chai
Zhen Lv
Publication date
01-12-2011
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2011
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-9-141

Other articles of this Issue 1/2011

World Journal of Surgical Oncology 1/2011 Go to the issue