Abstract
Objectives
The harmonic scalpel cuts and coagulates simultaneously using a mechanical vibration. We present our 1-year experience in the use Harmonic ACE(tm), Harmonic FOCUS(tm) and harmonic scalpel with 5 mm curved blade in head and neck surgery (Ethicon Endo-Surgery).
Methods
Over period of 1 year we performed 295 thyroidectomies, 23 parotidectomies, and 45 tonsillectomies using the harmonic scalpel. Control group consisted of 106 thyroidectomies, 9 parotidectomies, and 30 tonsillectomies that were performed over previous 5 months with the use of conventional hemostatic techniques (electrocautery and knot tying).
Results
The use of the harmonic scalpel shortened the duration of thyroid and parotid surgery by 20–30% as compared with the conventional techniques (p<0.05). The average skin incision length for those undergoing thyroidectomy with the harmonic scalpel was 1.8 cm shorter as compared with the conventional thyroidectomy group (p<0.05). Because of small skin incisions in thyroidectomy we preferred Harmonic ACE(tm) over Harmonic FOCUS(tm) due to longer shaft of scalpel, while Harmonic FOCUS(tm) was more suitable for parotidectomy. The use of Harmonic ACE(tm) shortened average duration of tonsillectomy by 5.5 minutes, while use of 5 mm curved blade (HF 105) did not affect significantly the average duration of tonsillectomy. Postoperative pain and complication rate were comparable for both groups (p>0.05).
Conclusions
The use of the harmonic scalpel reduces surgical time and intraoperative blood loss in head and neck procedures, and enables shorter incision length in thyroid surgery.
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