Safely increasing the efficiency of thyroidectomy using a new bipolar electrosealing device (LigaSure™) versus conventional clamp-and-tie technique

Abstract

Operative time in thyroid surgery can be safely reduced through use of a new bipolar electrosealing device (LigaSure). We evaluated consecutive patients undergoing thyroid surgery from January 2003 through January 2005 (n = 155). During the first half of the study, hemostasis was obtained using silk ties (conventional group, n = 70). During the second half of the study period, hemostasis was obtained with a bipolar electrosealing device (LigaSure group, n = 85). The mean operative time was 130 ± 37 minutes in the conventional group and 110 ± 33 minutes (P < 0.001) in the LigaSure group. EBL in the LigaSure group was statistically significantly less (43 ± 53 vs 33 ± 33 mL; P < 0.05). Postoperative calcium level was statistically significantly higher in the LigaSure group (8.2 ± 0.5 vs 8.4 ± 0.6 mg/dL, P < 0.05). Hospital length of stay (LOS) did not differ significantly. One patient in each group developed neck hematoma requiring reoperation. One permanent recurrent nerve injury occurred in the conventional group and one transient bilateral recurrent nerve injury occurred in the LigaSure group. The occurrence of symptomatic hypocalcemia was similar between the two groups. The training level of the surgical resident had no significant impact on the operative time, estimated blood loss (EBL), LOS, or complication rate. LigaSure bipolar electrosealer as the primary means of hemostasis during thyroidectomy significantly reduces mean operative times. Rates of operative complications were unchanged. LigaSure use in thyroid surgery can safely increase efficiency.