The use of “harmonic scalpel” versus “knot tying” for conventional “open” thyroidectomy: results of a prospective randomized stu

Abstract
Purpose  We evaluated the safety and cost-effectiveness of the harmonic scalpel (HS) during conventional “open” thyroidectomy (CT).

Materials and methods  Two hundred patients scheduled for conventional total thyroidectomy (TT) were included in the study and randomly assigned
to TT with the use of HS (HS group) or with knot tying technique (KT group).

Results  Mean operative time was significantly shorter in the HS group (P < 0.001), as well as the total operative room occupation time (P < 0.001). The cost of the disposable materials is significantly higher in the HS group (420.1 ± 23.2 vs 137.8 ± 25.3 euros;
P < 0.001). Conversely, drugs, personnel and operative room charges were significantly higher in KT group patients (P < 0.001). Overall, no significant difference was found between the two groups concerning the charges of the hospitalisation
(P = NS).

Conclusions  HS is a safe alternative to KT, allowing for a significant reduction of operative time without increasing complications rate
and overall costs and probably better utilization of health resources.

Content Type Journal ArticleCategory Current Concepts in Endocrine SurgeryDOI 10.1007/s00423-008-0380-9Authors
Celestino Pio Lombardi, Universitá Cattolica del Sacro Cuore Divisione di Chirurgia Endocrina, Istituto di Semeiotica Chirurgica L.go A. Gemelli 8 00168 Rome ItalyMarco Raffaelli, Universitá Cattolica del Sacro Cuore Divisione di Chirurgia Endocrina, Istituto di Semeiotica Chirurgica L.go A. Gemelli 8 00168 Rome ItalyAmerico Cicchetti, Universitá Cattolica del Sacro Cuore Unit of Health Technology Assessment Policlinico A. Gemelli, L.go A Gemelli 8 00168 Rome ItalyMarco Marchetti, Universitá Cattolica del Sacro Cuore Unit of Health Technology Assessment Policlinico A. Gemelli, L.go A Gemelli 8 00168 Rome ItalyCarmela De Crea, Universitá Cattolica del Sacro Cuore Divisione di Chirurgia Endocrina, Istituto di Semeiotica Chirurgica L.go A. Gemelli 8 00168 Rome ItalyRossella Di Bidino, Universitá Cattolica del Sacro Cuore Unit of Health Technology Assessment Policlinico A. Gemelli, L.go A Gemelli 8 00168 Rome ItalyLuigi Oragano, Universitá Cattolica del Sacro Cuore Divisione di Chirurgia Endocrina, Istituto di Semeiotica Chirurgica L.go A. Gemelli 8 00168 Rome ItalyRocco Bellantone, Universitá Cattolica del Sacro Cuore Divisione di Chirurgia Endocrina, Istituto di Semeiotica Chirurgica L.go A. Gemelli 8 00168 Rome Italy

Journal Langenbeck's Archives of SurgeryOnline ISSN 1435-2451Print ISSN 1435-2443 (Source: Langenbeck's Archives of Surgery)