@article {44028,
	title = {Thyroid surgery: comparison between the electrothermal bipolar vessel sealing system, harmonic scalpel, and classic suture ligation.},
	journal = {Am J Surg},
	volume = {195},
	year = {2008},
	month = {2008 Jan},
	pages = {48-52},
	abstract = {BACKGROUND: This study was conducted to compare the outcome of total thyroidectomy using the electrothermal bipolar vessel sealing system, the harmonic scalpel, and the classic suture ligation technique.

METHODS: This was a retrospective study of prospectively collected data from 382 consecutive total thyroidectomies from September 2004 to August 2006. Patients were divided into 3 groups: group SL patients (n = 90) underwent total thyroidectomy with the classic suture ligation technique, group L (n = 148) with the electrothermal bipolar vessel sealer, and group U (n = 144) with the harmonic scalpel. The main outcomes measured were surgical and hospitalization time, intraoperative and postoperative bleeding, postoperative hypocalcemia, and superior and inferior laryngeal nerves injuries.

RESULTS: The 3 groups were similar in terms of demographics, thyroid gland weight and pathology, perioperative complications, and hospital stay. Compared with the classic technique, surgical time was reduced significantly by about 20\% when the bipolar vessel sealer or harmonic scalpel was used (93.3 +/- 12.5 vs 74.3 +/- 14.2 and 73.8 +/- 13.8 min, P = .001, and P = .001, respectively).

CONCLUSIONS: Both the bipolar vessel sealer and harmonic scalpel are safe, useful, and time-saving alternatives to the traditional suture ligation technique for thyroid surgery. Because no differences were observed regarding these 2 devices, the choice should be made based on the surgeon{\textquoteright}s preferences and experience.},
	keywords = {Adult, Aged, Electrocoagulation, Female, Humans, Ligation, Male, Middle Aged, Retrospective Studies, Suture Techniques, Thyroid Diseases, Thyroidectomy, Time Factors, Treatment Outcome, Ultrasonic Therapy},
	issn = {1879-1883},
	doi = {10.1016/j.amjsurg.2007.01.037},
	author = {Manouras, Andreas and Markogiannakis, Haridimos and Koutras, Athanasios S and Antonakis, Pantelis T and Drimousis, Panagiotis and Lagoudianakis, Emmanuel E and Kekis, Panagiotis and Genetzakis, Michael and Koutsoumanis, Konstantinos and Bramis, Ioannis}
}
