Comparison of the harmonic focus and the thunderbeat for open thyroidectomy

Van Slycke, Sam; Gillardin, Jean-Pierre; Van Den Heede, Klaas; Minguet, Joan; Vermeersch, Hubert; Brusselaers, Nele

doi:10.1007/S00423-016-1448-6

Title

Comparison of the harmonic focus and the thunderbeat for open thyroidectomy

Author

Van Slycke, Sam

Gillardin, Jean-Pierre

Van Den Heede, Klaas

Minguet, Joan

Vermeersch, Hubert

Brusselaers, Nele

Abstract

An effective method for controlling haemostasis during open thyroidectomy procedures is crucial because of the high risks of haemorrhage and neck haematoma. This study aimed to demonstrate the efficacy of the integrated ultrasonic/bipolar Thunderbeat (TM) for this procedure. This retrospective non-inferiority study compared the Thunderbeat (TM) and the ultrasonic Harmonic FocusA (R) devices in 761 consecutive patients receiving a partial or total open thyroidectomy (with or without neck dissection). The main outcomes were duration of surgery, blood loss, and length of hospitalisation. Secondary outcomes were occurrence of hypocalcaemia, recurrent nerve paralysis, or other post-operative complications. A non-inferiority logistic regression approach was used to evaluate primary outcomes, adjusting for age, gender, body mass index, type of surgery, anaesthesiology score, and indication (benign or malign). The data demonstrated that the Thunderbeat was non-inferior to the Focus in terms of duration of surgery, blood loss, and length of hospital stay. Furthermore, subgroup analyses showed non-inferiority of the Thunderbeat for partial thyroidectomy (all three outcomes), total thyroidectomy (duration of surgery and length of hospitalisation), and total thyroidectomy with neck dissection (length of hospitalisation). In terms of recurrent nerve paralysis and post-operative complications, the Thunderbeat performed at least as well as the Focus; however, no conclusions could be drawn regarding the occurrence of post-operative hypocalcaemia. In a cohort of patients that underwent partial or total thyroidectomy, the Thunderbeat appeared to be at least as good as the Harmonic Focus.

Language

English

Source (journal)

Langenbeck's archives of surgery / Deutsche Gesellschaft für Chirurgie. - Berlin, 1998, currens

Publication

Berlin : Springer , 2016

ISSN

1435-2443 [print]

1435-2451 [online]

DOI

10.1007/S00423-016-1448-6

Volume/pages