Harmonic Scalpel is more Secure than Conventional Methods in Total Thyroidectomy: A Randomized Clinical Trial

Traditional haemostatic techniques in total thyroidectomy may cause some damages to surrounding tissues. It is believed that these damages can be reduced using ultrasonic dissector devices like Harmonic Scalpel (HS). In this study, we investigated the efficacy of ultrasonic dissectors (HS) versus conventional techniques (Clamp and Tie). A single blinded randomized clinical trial was performed at a referral educational center. Sixty eight eligible participants were enrolled and assigned to conventional group (operated with Clamp and Tie technique) and HS group (operated with Harmonic Scalpel). The following items were recorded in both groups: haemostatic technique, operative blood loss, duration of surgery, length of hospital stay, pathology, thyroid weight, postoperative recurrent laryngeal nerve injury, change in calcemia, pain, drainage volume and hematoma formation. The results demonstrated that application of HS in thyroidectomy significantly reduces operating time (P < 0.0001) and Intra operative bleeding (P < 0.0001). Postoperative drainage (P < 0.0001), pain (P < 0.0001), hypocalcemia (P < 0.0001), and length of hospitalization (P < 0.0001) were significantly lower in HS group. Voice score was significantly lower in HS group (P < 0.0001). HS in total thyroidectomy, reduces operating time, blood loss, postoperative pain, drainage volume, voice changes, and postoperative hypocalcemia, compared to conventional techniques.