Abstract:

Routine use of vascular sealing and dissecting devices was implemented in our Tertiary Center of Endocrine Surgery with a high volume of thyroid operations. Beginning with a prospective randomized trial on 82 patients that compared thyroid surgery with assistance of a new, high-frequency-powered electrothermal device (PreciseÔ, Covidien, Boulder, Colorado) to conventional thyroid surgery, approximately 30% of operation time was saved in the group using the device. Surgeons were then free to decide whether to use LigaSure (PreciseÔ), an ultrasonic device (FocusÔ, Ethicon Endo Surgery, Cincinnati, Ohio), or the classic tie-and-knotting procedure. This change of procedure resulted in an increase of surgery with devices, when compared to classic procedures from 20.2% to 98.4%, during a period of 5 years with 2,591 patients. The equal results of device-supported thyroid surgery were demonstrated when 100 consecutive patients with PreciseÔ and FocusÔ were compared, by measuring time of surgery (-36% or 43 min) and postoperative morbidity. The authors advocate the use of vascular sealing and dissecting devices for thyroid operations and, especially, for surgical units with high operative frequency.

Authors:

Peter E. Goretzki, M.D., Chief, Department of General Surgery, Abdominal Surgery, Coloproctology, and Hernia Surgery, , Lukaskrankenhaus, Neuss, Germany, Katharina Schwarz, M.D., Assistant Director Endocrine Surgery, Department of General Surgery, Abdominal Surgery, Coloproctology, and Hernia Surgery, Lukaskrankenhaus, Neuss, Germany, Berhard J. Lammers, M.D., Chief Operating Doctor, Coloproctology and Hernia Surgery, Lukaskrankenhaus, Neuss, Germany

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