Endocrine Abstracts

Background-objective: Although the harmonic scalpel has been shown to be safe and effective in thyroid surgery, several surgeons consider the previously available instruments to be large and cumbersome, especially in terms of dissection capabilities. To this context, an innovative technical improvement of the device for thyroid surgery has very recently been implemented and has been made available in 2008. Utilization of this new device, however, has not been evaluated in any study. We hypothesized that this instrument may result in further operative time reduction due to its greater tissue grasping and dissection capability. The aim of this study was to compare the results of total thyroidectomy using the new harmonic scalpel (FOCUS) to that with the previously available device (HARMONIC ACE).

Methods: Prospective randomized study of all total thyroidectomies between February and July 2008. Patients (n=90) were randomized into those submitted to total thyroidectomy with FOCUS (group A, n=45) and those with HARMONIC ACE (group B, n=45).

Results: No significant differences were identified between the two groups in terms of demographics, reoperative thyroid surgery, thyroid gland weight and diameter, pathologic diagnosis, preoperative and postoperative calcium, complications, hospital stay, and final outcome. Mean operative time was significantly shorter in group A than group B (63±7 vs 76±8.5 min, P=0.009).

Conclusions: The new harmonic scalpel device is a very useful adjunct to the thyroid surgeon’s armamentarium. It is safe, effective and hand-friendly, offering great tissue delicate grasping and dissection capabilities. Utilization of this device significantly reduced operative time compared to the previously available instrument.