Ultrasonic technology facilitates minimal access thyroid surgery.
OBJECTIVE
Options for controlling the vasculature during thyroid surgery include suture ligatures, vessel clips, and bipolar cautery. Ultrasonic technology represents an alternative to conventional techniques in which the vessels are simultaneously sealed and divided. We sought to determine the safety and efficacy of thyroidectomy with ultrasonic technology.


METHODS
Nonrandomized, prospective analysis of a series of patients undergoing thyroidectomy at the Medical College of Georgia.


METHODS
The records of 51 consecutive patients who underwent thyroid surgery between December 2004 and June 2005 were reviewed. Patients in whom ultrasonic technology (Harmonic-ACE, Ethicon Endo-Surgery, Cincinnati, OH) was used comprised the study population.


RESULTS
Forty-four of 51 patients underwent thyroidectomy with the assistance of ultrasonic technology. There were 4 males and 40 females with a mean age of 43.5 +/- 15.8 years. Twenty-two patients had a total thyroidectomy, 18 underwent unilateral lobectomy, and 4 underwent completion thyroidectomy. The overall mean incision length was 5.0 +/- 2.6 (range 2-12) cm. A subgroup of patients underwent minimally invasive video-assisted thyroidectomy (n = 13) and had a mean incision length of 29.3 +/- 0.8 mm. There were no cases of permanent injury to the recurrent laryngeal nerve and no cases of persistent hypoparathyroidism. Blood loss ranged from 5 mL to 100 mL, with a mean of 26.7 +/- 21.8 mL.


CONCLUSIONS
Ultrasonic technology facilitates thyroid surgery, particularly when a minimally invasive approach is undertaken. It reliably seals and divides the thyroid vasculature and will likely replace other methods of managing the thyroid blood supply.
Terris
David J
DJ
From the Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia 30912-4050, USA.
Seybt
Melanie W
MW
Gourin
Christine G
CG
Chin
Edward
E
D000328:Adult; D016063:Blood Loss, Surgical; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011446:Prospective Studies; D013961:Thyroid Gland / Q000098:blood supply*; D013965:Thyroidectomy / Q000295:instrumentation / Q000379:methods*; D014464:Ultrasonic Therapy / Q000295:instrumentation / Q000379:methods*; D020535:Video-Assisted Surgery