Energy-based vessel sealing device vs conventional clip and tie technique in thyroid surgery

Background. Hemostasis during thyroid surgery is critical for achieving satisfactory outcomes and ensuring a smooth postoperative recovery. For open thyroidectomy operations, the ergonomically constructed Focus Harmonic (FH) shears are the way to go. They make incisions, coagulation, and dissection easier. The purpose of the study is to compare the FH scalpel with conventional hemostasis (CH) in terms of operational duration, length of hospital stays, drainage volume, and surgical complications in open total thyroidectomy. Materials and methods. In this study, 120 patients were randomly assigned to one of two groups based on the surgical technique. Patients in group 2 were more often treated using the FH scalpel, in contrast to group 1 who underwent the conventional clamp-and-tie technique. The groups were assessed based on the following variables: drainage volume, length of hospital stay, number of problems, and duration of surgery. Results. The comparison of operating time indicated that the mean duration of surgery was considerably reduced in the FH group (71.3 ± 11.1 minutes) compared to the CH group (85.7 ± 15.5 minutes) (P < 0.001). The drainage volume in the Focus group was substantially lower than in the conventional group, measuring 38.0 ± 14.4 cc compared to 58.6 ± 23.7 cc, respectively (P < 0.001). The length of hospital stay was markedly prolonged in the CH group, averaging 28.2 ± 11.3 hours, in contrast to 20.4 ± 4.3 hours in the FH group (P < 0.001). In complete thyroidectomy, our findings indicate that the FH approach is more successful than the CH procedure. The surgery duration is reduced, total drainage fluid volume is diminished, and hospital stay is shortened, with no significant impact on recurrent laryngeal nerve or temporary symptomatic hypocalcemia. The Focus Harmonic scalpel is considered a safe and dependable device compared to the clamp-and-tie procedure in complete thyroidectomy. Conclusions. The Focus Harmonic scalpel may reduce operation duration, hospital length of stay, and drainage volume. It is deemed a safe and dependable device compared to the clamp-and-tie approach in complete thyroidectomy.