Implementing the general use of dissection devices in thyroid surgery from prospective randomized trial to daily use
Goretzki, P.E.; Schwarz, K.; Lammers, B.J.
Surgical Technology International 18: 86-92
2009
ISSN/ISBN: 1090-3941 PMID: 19579193 Document Number: 632087
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 (Precise™, 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 (Precise™), an ultrasonic device (Focus™, 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 Precise™ and Focus™ 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.