title: Sutureless thyroidectomy.
abstract: OBJECTIVE
  The ultrasonic scalpel is a surgical shear that uses high-frequency mechanical energy to enable simultaneous vessel sealing and tissue coagulation at the same time. We conducted a prospective study to compare the outcome of total thyroidectomy using the ultrasonic scalpel versus the device Ligasure in terms of safety, operative time, overall drainage volume, complications, hospital stay.
  
  
  METHODS
  Between January 2008 and December 2013,400 patients (260 women, 140 men; mean age 46 years) undergoing thyroidectomy were randomized into two groups: group A, where Ultracision were used, and group B, where the Ligasure device was used.
  
  
  RESULTS
  There was no significant differences between the two groups in terms of age, gender, indication for thyroidectomy, thyroid gland weight and diameter, histopathologic diagnosis, preoperative and postoperative serum calcium levels, postoperative complications and reoperative thyroid surgery, time of operation and amount of drainage.
  
  
  CONCLUSIONS
  The ultrasonic scalpel and the Ligasure ares safe, effective, useful, and time-saving alternative to the traditional suture ligation technique for thyroid surgery. They simplified total thyroidectomy, eliminating the need for clamp-and-tie maneuvers while achieving efficient hemostasis.
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Ruggiero
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Italy.
authors.forename: Adelmo
authors.initials: A
authors.lastname: Gubitosi
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Gili
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Bosco
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pirozzi
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Italy.
authors.forename: Cosma
authors.initials: C
authors.lastname: Cosenza
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rossetti
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Italy.
authors.forename: Landino
authors.initials: L
authors.lastname: Fei
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Italy. Electronic address: giovanni.docimo@unina2.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Docimo
authors.affiliation: Division of General Surgery, Department of Surgery, Second University of Naples, Italy.
authors.forename: Ludovico
authors.initials: L
authors.lastname: Docimo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D013536:Suture Techniques; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Hemostasis; Ligasure device; Thyroidectomy; Ultrasonic device