FOCUS Harmonic Scalpel Compared to Conventional Hemostasis in Open Total Thyroidectomy: A Prospective Randomized study

Dr.Raad Saad Al Saffar MBChB , CABS , consultant laparoscopic and thyroid surgeon
Dr. Ali Yaseen Ali , MBChB

Abstract
Background:
Hemostasis in thyroid surgery is of utmost importance for a successful surgery and an uneventful postoperative course.
Aim of the Study:
To make comparison between FOCUS harmonic scalpel and conventional hemostasis regarding operative time , hospital stay, drainage volume and surgical complication in open total thyroidectomy
Patients and methods:
In this study, 120 patients were randomized into 2 groups based on the surgical technique used: group I comprised the conventional clamp-and-tie technique, group II comprised patients in whom the FOCUS Harmonic Scalpel was used in majority of steps . The groups were compared in regard to operative time, complications, and hospital stay and drainage volume .
Results:

Comparison of operative time, revealed that the mean operation time was significantly shorter in FOCUS group (71.3±11.1) minutes compared to (85.7± 15.5) minutes in conventional group, (P<0.001).
Similarly , drainage volume was significantly smaller in FOCUS group than conventional, 38.0 ± 14.4 vs. 58.6 ± 23.7 cc cc, respectively, (P<0.001). Hospital stay was significantly longer in conventional group where the duration of stay was 28.2 ± 11.3 hours compared to 20.4 ± 4.3 hours in FOCUS group, (P<0.001).

Conclusions:

The FOCUS Harmonic Scalpel can shorten operative time and hospital stay, and less drainage volume . FOCUS Harmonic Scalpel is found to be safe and reliable instrument as the clamp-and-tie technique in total thyroidectomy.