BACKGROUND & OBJECTIVE: Thyroidectomy is a classic surgical procedure used worldwide for thyroid gland excision. A study was conducted to compare the outcomes (mean operative time, drainage volume, ...postoperative pain and hospital stay) and postoperative complications of Harmonic scalpel and conventional homeostasis in patients who underwent total thyroidectomy METHODOLOGY: A prospective observational study was conducted at the department of general surgery, POF hospital Wah Cantt. The study duration was six months (June 2020-Novemebr 2020). A sample size of 70 patients was calculated using the WHO calculator. Patients for total thyroidectomy were selected through a non-probability consecutive sampling. Patients whose total thyroidectomy was planned were divided into two groups using a random number table. In Group A, we used a harmonic scalpel, while in Group B, we used the conventional homeostasis method to secure homeostasis operatively. Patients were followed after 4 weeks for complications. Chi-Square test and t-test was applied. RESULTS: A total of 70 patients were included in the study. The mean operative time was 44.5 min±1.4 in the HS group and 66.0 min±2.0 in the conventional homeostasis group (p≤0.001). Hospital stay was significantly less in the HS group as compared to the conventional homeostasis group (2.3 days ±0.4 vs 3.3 days ±0.4, p≤0.001). Postoperative drainage was significantly high in conventional homeostasis group as compared to HS group (56.4±1.5 mL vs 36.5±1.5 mL, p≤0.001). CONCLUSION: Harmonic scalpel is an effective, reliable and safe tool for better outcomes in terms of less operative time, lower drainage volume and short duration of hospital stay as compared to conventional methods.
Background: Thyroid operation needs very meticulous haemostasis to have minimal morbidity and mortality.
Objectives: Assessment of harmonic knife in open thyroid surgery as anew haemostatic ...procedure .
Type of the study: Cross-sectional study.
Methods: This study had been conducted at Alkindy teaching hospital in Baghdad city from the 1st of May 2013 to the 1st of January 2017 on 229 goiterous patients who needs thyroidectomy(36 males,193 females),divided in 2 groups according to the haemostatic procedure used during their operations, Group A (15 males,85females)using the usual conventional surgery(pick, tie &cut), Group B (21males,108 females) using harmonic knife as haemostatic procedure and compare the results according to time of surgery, amount of discharge in the drain during the first 24 hours post operatively ,the incidence of recurrent nerve palsy and the remote post operative hypocalcaemia (3months post operation) .
Results: It shows that thyroid surgery (thyroidectomy) by using harmonic knife as haemostatic procedure is shorter in duration mean67.22 minutes with less blood loss in the
drain mean 64.96cc and less incidence of hypocalcaemia in remote post operative period 3.8% in comparison to the results of the usual conventional thyroidectomy procedures (mean duration 82.02 minutes, mean blood loss in the drain 111.13cc & incidence of hypocalcaemia is 7%}.
Conclusions: Harmonic knife is very safe & beneficial haemostatic device in thyroid surgery.
The present study aims to compare the clinical efficacy of laparoscopic partial nephrectomy using a harmonic scalpel versus traditional scissor.
A retrospective review was conducted in patients with ...localized renal tumors and scheduled for laparoscopic partial nephrectomy from January 2015 to December 2019. Eventually, 225 patients joined this retrospective study. Patients were divided into the harmonic scalpel group or scissor group based on the method used, with 71 cases and 154 cases respectively. Propensity score matching (1:1) was performed to adjust for potential baseline confounders, and each group had 57 cases. Patient characteristics, perioperative clinical results, complications, and oncological results were compared between the two groups.
After matching, patient characteristics were not significantly different between the two groups. The scissor group was associated with a significantly shorter operative time (105 min vs. 130 min, p < 0.001), shorter warm ischemia time (19.35 min vs. 22.07 min, p = 0.005). However, the harmonic scalpel group was associated with significantly less estimated blood loss (20 mL vs. 30 mL, p = 0.013) and shorter length of stay (8 d vs. 10 d, p = 0.040). There was no significantly difference in indwelling time of drainage tube, perioperative complication, oncological outcomes or recurrence rates.
The harmonic scalpel is used safely and effectively in laparoscopic partial nephrectomy, and has benefits in intraoperative blood loss and length of stay.
The current, retrospective study aimed to assess the short-term prognosis and postoperative complications associated with the surgical correction ofelongated soft palate using harmonic scalpel and to ...compare the postoperativecomplications associated with the application of harmonic scalpel and traditional surgery using Metzenbaum scissors. Harmonic scalpel was used to performstaphylectomy in 21 dogs. A total of ten dogs underwent sacculectomy; six dogswith harmonic scalpel and four dogs using Metzenbaum scissors. Stenotic nareswere corrected by wedge resection. Postoperative complications were recordedthrough monitoring and radiographic examinations. Telephone interviews wereconducted on the first, third, and seventh day after discharge and continueduntil the resolution of postoperative complications. Postoperative edema at thesurgical site was identified and mitigated within a day or two. Snoring and dyspnea improved dramatically in the group that underwent staphylectomy alone.
Moreover, three dogs presented with postoperative gastrointestinal complications, especially retching. The symptoms persisted for seven days and ten daysin two dogs that underwent sacculectomy with harmonic scalpel and for twodays in one dog that underwent sacculectomy with Metzenbaum scissors. Theclinical signs and symptoms of brachycephalic syndrome disappeared withoutrecurrence. Harmonic scalpel provides a hemostatic effect during staphylectomy, is convenient, and does not cause postoperative complications. Conversely,the use of harmonic scalpel during sacculectomy necessitated a longer periodfor the resolution of complications without any significant hemostatic efficacy,compared to traditional surgery. KCI Citation Count: 0
Transaxillary endoscopic dual-plane breast augmentation is becoming increasingly mature. The intraoperative separation of the implant into the space is often performed using monopolar cautery. The ...use of the harmonic scalpel has proved more beneficial in several surgeries. However, no study has ever addressed the effects of harmonic scalpel usage compared to monopolar cautery in transaxillary endoscopic dual-plane breast augmentation.
In this randomized controlled study, we enrolled patients (n = 78) who underwent breast augmentation in our hospital from January to October 2022. Participants were randomized with an intentional unequal allocation ratio (2:1 in the harmonic scalpel group: monopolar cautery group). Outcome measures included: total postoperative drainage volume, postoperative drainage volume for the first 24 h, number of postoperative drainage days, daily pain scored through the visual analog scale, operative time, and reoperation rate.
A total of 51 patients in the harmonic scalpel group and 24 patients in the monopolar cautery group were analyzed. Overall, in comparison to the monopolar cautery group, the harmonic scalpel group showed improved total postoperative drainage volume, postoperative drainage volume for the first 24 h, number of postoperative drainage days, and postoperative pain scores. No differences were found regarding operative time and reoperation rate.
Compared with monopolar cautery, harmonic scalpel usage in transaxillary endoscopic breast augmentation has evident advantages regarding postoperative drainage and patients' pain scores, making it an instrument worth of recommendation.
To compare clinical outcomes in patients with and without history of tobacco use who underwent Zenker's diverticulotomy (ZD).
Single institution retrospective review.
Tertiary care academic hospital.
...A retrospective review of patients who underwent ZD via an open stapler, rigid endoscopic CO2 laser, stapler or harmonic scalpel, and flexible endoscopic technique from January 2006 to December 2020 was performed. Data were abstracted for patient demographics, diverticular features, and rates of adverse events and symptomatic recurrence.
Out of 424 patients, 146 (34.4 %) had a history of tobacco use: 126 (29.7 %) were former smokers, and 20 (4.7 %) were active smokers. In univariable cross-sectional analyses, the likelihood of postoperative bleeding, perforation, emergency department visits, unplanned readmission, or recurrence did not demonstrate an association with tobacco use history even after adjustment for age, sex, and surgical approach. Similarly, in Cox Proportional Hazards regression, tobacco use was not associated with an increased risk of recurrence, even after correcting for age, sex, and type of surgery. The median time to recurrence observed in our cohort was 11.5 years amongst non-smokers, 8.7 years amongst former smokers, and 1.2 years amongst active smokers (p = 0.94).
There were no significant differences in post-operative adverse events or frequency of recurrence of ZD between active, former, and non-smokers. Although underpowered and not statistically significant, median time to recurrence appears to be shorter in smokers when compared with former and non-smokers following surgery.
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