The Use of Harmonic Scalpel in Subtotal Thyroidectomy: Single Centre Experience

Abstract
Background: In conventional subtotal thyroidectomy, the use of clamp and tie technique combined with electrocautery consumes longer time and can cause much blood loss and recurrent laryngeal nerve damage.
Patients and Methods: Our study included 40 patients scheduled for open subtotal thyroidectomy and were divided into two groups each contain 20 patient, the first group undrewent subtotal thyroidectomy using the traditional clamp and tie technique and the second group using the Harmonic Focus Scalpel, then we compared between the two groups concerning operative time, post-operative pain, RLN injury, seroma and wound infection, hypothyroidism and hospital stay.
Results: The mean operative time for group 1 was (147.25± 25.88) and (125.75±20.34) for group 2 with the p-value (0.008). The mean post-operative drainage volume (in CC) was (24.75±4.69) for group 1 and (18.60±4.02)for group 2 with p-value (0.001).
Other post-operative complications (RLN damage, pain, hypocalcaemia, haematoma) in both groups were statistically insignificant. Post-operative hospital stay was the same for both groups.
Conclusion: In our results we founded that the operative time has been decreased, also the post-operative drainage volume has been decreased in group two where we used the Harmonic Focus Scalpel. Post-operative pain and other com-plications like recurrent laryngeal nerve injury or hypocalcae-mia were the same in both groups. Days of hospitalization were the same in both groups. According to our experience in Assiut University Hospital the use of Harmonic Focus Scalpel is safe and effective during open subtotal thyroidectomy and can improve the surgical outcome.