title: Impact of the use of vessel sealing or harmonic scalpel on intra-hospital outcomes and the cost of thyroidectomy procedures.
abstract: OBJECTIVE
  To analyze the operative time, length of hospitalization and cost, as well as the bleeding and pain observed during the postoperative period, of thyroidectomy procedures using vessel sealing, harmonic scalpel or the conventional technique.
  
  
  METHODS
  Retrospective analysis of thyroidectomies performed between 2007 and 2010 using either the conventional technique or minimally invasive techniques involving vessel sealing or a harmonic scalpel. Gender, age, primary diagnosis and procedure type were analyzed. The outcomes analyzed included the length of the procedure, length of hospital stay, need for blood product transfusions, pain and cost of hospitalization. The findings were based on a significance level of 5%, and statistical analyses were performed using the R software.
  
  
  RESULTS
  The use of the vessel sealing increased the duration of the surgery by approximately 47 minutes compared to the conventional technique (p<0.001), and the use of the harmonic scalpel decreased the duration of the surgery by approximately 32 minutes compared to the conventional technique (p<0.001). No statistically significant difference was found between the groups regarding the use of blood products and pain score. Procedures involving vessel sealing or a harmonic scalpel cost more than those using the conventional technique.
  
  
  CONCLUSIONS
  The use of harmonic scalpel was favorable in terms of reducing the surgical time, but there was no reduction in hospitalization time. The cost of the procedure was higher than that of the conventional technique. The use of vessel sealing offered no advantages in terms of the outcomes assessed, and the cost of the procedure was greater than that of the conventional technique.
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
authors: Fabricia Bersi
authors: FB
authors: da Silva
authors: Ana Claudia de Oliveira
authors: AC
authors: Limoeiro
authors: Juliana
authors: J
authors: Del Bianco
authors: Vanessa
authors: V
authors: Teich
authors: Nelson
authors: N
authors: Teich
authors: José Carlos
authors: JC
authors: Teixeira
authors: Ana Luiz
authors: AL
authors: Vasconcelos
authors: Camila
authors: C
authors: Sardenberg
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D057186:Comparative Effectiveness Research; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain; D012189:Retrospective Studies; D013525:Surgical Instruments; D013965:Thyroidectomy / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome