Evaluation of the Ultracision (R) ultrasonic dissector in thyroid surgery.A prospective randomized study

Study objective : This prospective randomized study was designed to evaluat e the efficacy, safety and cost of the ultrasonic hook in thyroid surgery, in comparison with conventional hemostasis. Methods : Thirty-four consecutive euthyroid patients with multinodular goit er undergoing total thyroidectomy were randomly assigned to either group I, Ultracision(R) or group II, conventional hemostasis. Preoperative, intraop erative and postoperative biochemical, clinical, surgical and economic vari ables were compared in each group. Results : Use of the ultrasonic hook resulted in a significant reduction in operating time (70.7 +/- 18.3 versus 96.5 +/- 28.9 minutes), blood loss (7 4.5 +/- 50.9 g versus 134.6 +/- 108.42 g), and postoperative analgesic cons umption (paracetamol (mg): 700 +/- 722 versus 1888 +/- 978), and may also r educe the incidence of transient hypoparathyroidism (5.8% versus 23.5%). Th e ultrasonic hook was no more expensive than conventional hemostasis, as lo ng as a minimum of 15 patients shared the initial unit cost of the device. Conclusion : Although the use of the ultrasonic dissector does not allow a major cost-saving in total thyroidectomy, the essential advantages were a s ignificant reduction of intraoperative blood loss, length of operating time and postoperative analgesic consumption. (C) 2000 Editions scientifiques e t medicales Elsevier SAS.