Minimally invasive video-assisted thyreoidectomy (MIVAT) with and without use of harmonic scalpel—a randomized study

Background and aims Minimally invasive video-assisted thyroidectomy (MIVAT) has been used for the removal of small thyroid nodules to improve cosmetic results and diminish pain. The aim of this study was to compare the outcomes of the MIVAT operations with and without the use of an ultrasonic harmon...

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Bibliographic Details
Published in:Langenbeck's archives of surgery 2008-09, Vol.393 (5), p.647-654
Main Authors: Barczyński, Marcin, Konturek, Aleksander, Cichoń, Stanisław
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adenocarcinoma, Follicular - diagnostic imaging
Adenocarcinoma, Follicular - surgery
Adult
Cardiac Surgery
Controlled Prospective Clinical Trials
Esthetics
Female
Follow-Up Studies
General Surgery
Hemostasis, Surgical - instrumentation
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Minimally Invasive Surgical Procedures - instrumentation
Patient Satisfaction
Postoperative Complications - etiology
Surgical Instruments
Thoracic Surgery
Thyroid Neoplasms - diagnostic imaging
Thyroid Neoplasms - surgery
Thyroid Nodule - diagnostic imaging
Thyroid Nodule - surgery
Thyroidectomy - instrumentation
Traumatic Surgery
Ultrasonic Therapy - instrumentation
Ultrasonography
Vascular Surgery
Video-Assisted Surgery - instrumentation
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Summary:Background and aims Minimally invasive video-assisted thyroidectomy (MIVAT) has been used for the removal of small thyroid nodules to improve cosmetic results and diminish pain. The aim of this study was to compare the outcomes of the MIVAT operations with and without the use of an ultrasonic harmonic scalpel (HS). Patients and methods Seventy-six patients with a solitary thyroid nodule below 30 mm in diameter were randomized to two groups of 38 patients each. Unilateral thyroid lobectomy was performed in each patient. In the clip-ligation group (CL-G), during MIVAT, the superior thyroid vessels were clipped and bipolar coagulation was used to secure smaller vessels, whereas in the harmonic scalpel group (HS-G), HS was used to dissect and divide all the thyroid vessels. The statistical analysis included the mean operative time, blood loss, postoperative morbidity, scar length, cosmetic satisfaction at 1 and 6 months following surgery, and cost-effectiveness. Results HS-G vs CL-G operations were shorter (31.4 ± 7.7 vs 47.5 ± 13.2 min; p  
ISSN:1435-2443
1435-2451
DOI:10.1007/s00423-008-0373-8