Comparison of Harmonic Scalpel versus conventional hemostasis in Thyroid surgery in terms of per-operative and postoperative outcome.

  • Mumtaz Ali Govt Teaching Hospital Shahdara, Lahore.
  • Mudassar Murtaza Govt Teaching Hospital Shahdara, Lahore.
  • Mohammad Aleem-ud-Din Sahara Medical College Narowal.
  • Mohammad Burhan ud Din Jinnah Hospital, Lahore.
  • Assam Sarwar Govt Teaching Hospital Shahdara, Lahore.
  • Ansar Aslam Gujranwala Medical College.
Keywords: Blood Loss, Harmonic Scalpel, Laryngeal Nerve Injury, Open Surgery, Pain, Thyroidectomy

Abstract

Harmonic scalpel is popular for use in a variety of surgical procedures including thyroid surgery. Proposed advantages of the harmonic scalpel include less lateral thermal tissue damage with no electrical energy transferred to the patient, no neuromuscular stimulation, less smoke formation as compared with electrocautery. Objectives: Our aim was to compare outcomes following thyroid surgery in terms of operative time, postoperative pain, drainage volume, recurrent laryngeal nerve and parathyroid gland injury with the use of the Harmonic Scalpel compared to conventional methods of hemostasis. Study Design: Randomized control trial. Setting: Surgical Department Lahore General Hospital. Period: Twelve Months June 2016 to June 2017. Material & Methods: 60 patients, 30 in each group. Patients were randomized in each group by balloting method. Operative time, postoperative pain and drainage volume was assessed during hospital stay. Recurrent laryngeal nerve and parathyroid gland injury was assessed during hospital stay and follow-up. Results: There was no significant difference in development of hoarseness of voice in both groups, p-value > 0.05. The mean operative time for group A was 69.47 ± 15.44 minutes and for group B it was 54.93 ± 11.56 minutes, p-value <0.05. The overall blood loss in group-A and group-B was 118.73 ± 50.72 ml and 44.60±10.70 ml, p-value<0.05. The mean post-op pain observed at 2nd day for group B was 2.93 ±3.57 and for group A it was 3.57±0.77, p-value < 0.05. Conclusion: Use of Harmonic Scalpel has better results in thyroid surgery in terms of less operative time, less postoperative pain, less drainage volume, while no RLN & parathyroid injury detected in either group.

Author Biographies

Mumtaz Ali, Govt Teaching Hospital Shahdara, Lahore.

MBBS

Registrar Surgery  

 

Mudassar Murtaza, Govt Teaching Hospital Shahdara, Lahore.

FCPS

Assistant Professor Surgery

 

Mohammad Aleem-ud-Din, Sahara Medical College Narowal.

FCPS

Assistant Professor Cardiology

 

Mohammad Burhan ud Din, Jinnah Hospital, Lahore.

MBBS

Registrar

Department of ENT

 

Assam Sarwar, Govt Teaching Hospital Shahdara, Lahore.

MBBS

Medical Officer

Department of Surgery

 

Ansar Aslam, Gujranwala Medical College.

FCPS

Senior Registrar Surgery

 

Published
2020-01-10