Background: Hemostasis in thyroid surgery is of utmost importance for a
successful surgery and an uneventful postoperative course. The present
article reports a single surgeon’s 3-year experience in the use of the
harmonic scalpel. The device was developed in the early 1990s and
offered adequate and safe hemostasis for vessels up to 3 min in width.
Methods: This was a prospective observational study. Data sheets from
all patients who had surgery by a single endocrine surgeon in the period
from 1999 to 2004 were evaluated. Patients were divided into 3 groups
based on the surgical technique used: group I comprised the conventional
knot-and-tie technique, group II comprised the ligation of all but the
superior thyroid vessels with a scalpel, and group III comprised
patients in whom the device was used exclusively. The groups were
compared in regard to surgical time, cost, and complication rate.
Results: A total of 272 patients were included in the study: 107
patients were included in group 1, 77 in croup 11, and 88 group III. The
surgical time of group I differed significantly compared with groups II
and III (P <.0001 in both cases). Surgical times between groups II and
III did not differ significantly (P = .701).
Conclusions: The use of the harmonic scalpel reduces surgical time, but,
it increases the cost of the surgery. It is our belief that by including
in the absolute cost the time saved and the reduction in human resources
needed, the use of the scalpel would prove to be economic. (C) 2007
Published by Excerpta Medica Inc
