ABSTRACT
Objective: Harmonic Focus (Ethicon, Johnson and Johnson, Cincinnati, OH, USA), LigaSure Small Jaw (Medtronic, Covidien Products, Minneapolis, MN, USA), and Thunderbeat Open Fine Jaw (Olympus, Japan) are electrosurgical instruments used widely in head and neck surgery. The study aims to compare device malfunctions, adverse events to patients, operative injuries, and interventions related to Harmonic, LigaSure, and Thunderbeat use during thyroidectomy. Methods: The US Food and Drug Administration's Manufacture and User Facility Device Experience (MAUDE) database was queried for adverse events associated with Harmonic, LigaSure, and Thunderbeat from January 2005 to August 2020. Data were extracted from reports pertaining to thyroidectomy. Results: Of the 620 adverse events extracted, 394 (63.5%) involved Harmonic, 134 (21.6%) LigaSure, and 92 (14.8%) Thunderbeat. The reported device malfunctions most frequently associated with Harmonic was damage to the blade (110 (27.9%)), LigaSure was inappropriate function (47 (43.1%)), Thunderbeat was damage to the tissue or Teflon pad (27 (30.7%)), respectively. Burn injury and incomplete hemostasis were the most commonly reported adverse events. The operative injury reported most frequently when using Harmonic and LigaSure was burn injury. No operator injuries were reported with Thunderbeat use. Conclusion: The most frequently reported device malfunctions were damage to the blade, inappropriate function, and damage to the tissue or Teflon pad. The most frequently reported adverse events to patients was a burn injury and incomplete hemostasis. Interventions aimed at improving physician education may help reduce adverse events attributed to improper use.
ABSTRACT
Background: Remarkable increase in incidence of thyroid cancer over previous decade has resulted in increased need for thyroid surgery. Aim and objectives: Goal of research was to evaluate safety and efficacy of using vessel sealing device ligasure (COVIDIEN®) in terms of intraoperative and postoperative complications, comparing to standard vascular ligation in open thyroid surgery. Patients and methods: A randomized-controlled trials that was conducted at Department of General Surgery of Assiut University Hospitals. A total of 80 patients were scheduled for thyroidectomy participated in the research. Those patients were randomly subdivided into 2 categories. Category 1 included cases who underwent conventional vessel ligation (n= 40 patient) and category 2 included cases who underwent ligasure vessel sealing (n=40 patients). The study was conducted in the period between 2019 and 2021. Results: Both groups had insignificant difference regarding overall recorded complications (8 (20%) vs. 7 (17.5%);p= 0.51). One patient in each group developed hoarseness while recurrent transient laryngeal nerve damage was recorded in two patients in each category. The most frequent complication was transient hypocalcaemia (12.5% of conventional ligation and 10% of ligasure sealing group). Conclusion: Ligature was superior to conventional approach in terms of lowering operation time, perioperative and postoperative blood loss, and parathyroid damage. RLN injuries, on the other hand, were comparable in both categories. Although shorter operative periods led to lower operating room occupancy expenses, overall cost of surgery was considerably greater in ligasure category. © 2022, Ain Shams University Faculty of Medicine. All rights reserved.
ABSTRACT
OBJECTIVE: The standard treatment for patients with placenta percreta is cesarean hysterectomy that can cause severe bleeding. New-generation vessel sealing systems like LigaSure can cut and seal vascular structures and tissues. The aim of this study was to retrospectively compare hysterectomies performed with traditional instruments and those performed with LigaSure instruments to determine the possible advantages with the latter. MATERIALS AND METHODS: Patients with placenta percreta who underwent elective cesarean hysterectomy by the same surgeon were divided into two groups based on the type of instruments used. Group 1, the standard conventional hysterectomy group, operated with conventional instruments for cutting and tying; and Group 2, the LigaSure hysterectomy group, operated with the new-generation bipolar sealing and cutting instruments. The groups were retrospectively compared for bleeding, operating time, and complications. RESULTS: In Group 2, the operating time, intraoperative and total transfused erythrocyte suspension units, total fluid in the drain, and total hospital stay were lower than in Group 1 (p < .05), as was the need for internal iliac artery ligation (p = .013). The complication rates were similar between the two groups (p > .05). CONCLUSION: The use of LigaSure open instruments in cesarean hysterectomies in patients with placenta percreta may reduce operating times and the amount of bleeding.