Use of the Electrothermal Vessel Sealing System Versus Standard Vessel Ligation in Thyroidectomy

The electrothermal vessel sealing system (LigaSure(tm)) facilitates operative haemostasis by fusing blood vessel walls to form a collagen seal. The LigaSure(tm) is currently used in a variety of gastrointestinal, gynaecological and urological operations. We report our experience with LigaSure(tm) for thyroidectomy to test the hypothesis that it reduces operating time without increasing complications compared with standard vessel ligation. Methods: This non-randomized, retrospective review included 234 consecutive patients who underwent thyroidectomy by one surgeon. Standard vessel ligation was used in 99 patients between 1997 and 2000, and the LigaSure(tm) was used in 135 patients between 2001 and 2003. The following data were collected: patient demographics, thyroid pathology, type of operation (total thyroidectomy vs lobectomy), operating time, complications (transient or permanent hypocalcaemia, ! 8 mg/dL), recurrent or superior laryngeal nerve injury, neck haematoma, wound complications, prolonged intubation), incision length and hospital stay. Results: The two groups had similar demographics, thyroid pathology, types of operations and complication rates. The LigaSure(tm) group had lower operating times and incision lengths. Conclusion: We found that the LigaSure(tm) was as safe as standard vessel ligation for thyroidectomy, with the benefit of reduced operating time. A future prospective study has been designed