Thyroidectomy using the harmonic scalpel: Analysis of 105 consecutive cases

OBJECTIVE. The purpose of this report was to evaluate the technical benefits, if any, of thyroidectomy using the harmonic scalpel versus conventional thyroidectomy. STUDY DESIGN: One hundred five consecutive patients underwent thyroidectomy over 1 year with use of the harmonic scalpel. They were compared with a group of 20 patients who underwent thyroidectomy 1 year earlier using conventional techniques. RESULTS: The incision length for those undergoing thyroidectomy with the harmonic knife averaged 4.5 cm compared with 5.5 cm for the conventional thyroidectomy group. The operating time for a hemithyroidectomy averaged 50 minutes for the harmonic scalpel group versus 80 minutes for the conventional technique. The operating time for a total thyroidectomy averaged 80 minutes for the harmonic scalpel group versus 120. minutes for the conventional thyroidectomy group. CONCLUSION: The use of the harmonic scalpel in thyroid surgery offers several advantages over the conventional technique. The incision length is shorter and the operating time is reduced. Bleeding is negligible and complications are few. SIGNIFICANCE., The harmonic scalpel, whose use was pioneered in laparoscopic surgery, offers the thyroid surgeon the ability to safely and expeditiously control the feeding vessels through a limited field.