title: Implementing the general use of dissection devices in thyroid surgery from prospective randomized trial to daily use.
abstract: Routine use of vascular sealing and dissecting devices was implemented in our Tertiary Center of Endocrine Surgery with a high volume of thyroid operations. Beginning with a prospective randomized trial on 82 patients that compared thyroid surgery with assistance of a new, high-frequency-powered electrothermal device (Precise™, Covidien, Boulder, Colorado) to conventional thyroid surgery, approximately 30% of operation time was saved in the group using the device. Surgeons were then free to decide whether to use LigaSure (Precise™), an ultrasonic device (Focus™, Ethicon Endo Surgery, Cincinnati, Ohio), or the classic tie-and-knotting procedure. This change of procedure resulted in an increase of surgery with devices, when compared to classic procedures from 20.2% to 98.4%, during a period of 5 years with 2,591 patients. The equal results of device-supported thyroid surgery were demonstrated when 100 consecutive patients with Precise™ and Focus™ were compared, by measuring time of surgery (-36% or 43 min) and postoperative morbidity. The authors advocate the use of vascular sealing and dissecting devices for thyroid operations and, especially, for surgical units with high operative frequency.
authors: Department of General Surgery, Abdominal Surgery, Coloproctology, and Hernia Surgery, Lukaskrankenhaus, Neuss, Germany.
authors: Peter E
authors: PE
authors: Goretzki
authors: Katharina
authors: K
authors: Schwarz
authors: Berhard J
authors: BJ
authors: Lammers
mesh_terms: D004867:Equipment Design; D019544:Equipment Failure Analysis; D005858:Germany / Q000453:epidemiology; D006801:Humans; D013536:Suture Techniques / Q000295:instrumentation* / Q000706:statistics & numerical data*; D013965:Thyroidectomy / Q000295:instrumentation* / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D059708:Ultrasonic Surgical Procedures / Q000295:instrumentation* / Q000706:statistics & numerical data*; D016526:Workload / Q000706:statistics & numerical data*