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Use of Ligasure Sealing Versus Conventional Suture - Ligation in Total Thyroidectomy

Received: 8 April 2016     Accepted: 10 April 2016     Published: 4 June 2016
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Abstract

Introduction: Effective vessel haemostasis can be achieved by suture knot tying technique or newer techniques of vessel haemostasis like ligasure as an alternative bipolar surgical diathermy system. Various diathermy techniques have been proposed to reduce intraoperative blood loss in surgery and the new electrothermal bipolar tissue sealing system (Ligasure) has been applied in various specialties of surgery. The objective of this randomized study was to compare the outcome of ligasure versus conventional clamping and tie in total thyroidectomy for benign thyroid diseases. Patients and Methods: A total of 200 patients diagnosed to have bilateral BMNG were subjected to primary total thyroidectomy and divided into two main groups Ligasure (L) and Suture-Ligation (SL). For detection of laryngeal nerves status, vocal cords were checked immediately postoperatively by laryngoscope and at the day 10 of postoperative period to assess the status of both laryngeal nerves. The function of the parathyroids was checked by detecting the serum calcium concentration and parathyroid hormone level. The following parameters were measured to compare the effect of ligasure versus conventional suture-ligation technique in decreasing the operative blood loss, operative time, securing laryngeal nerves and parathyroids, postoperative drainage and postoperative wound infection. Results: There was no statistical difference between the two groups regarding age, sex and body mass index and also there was no operative mortality. As regard the operative time, in ligasure group it was 115.54 ±15.35 minutes while in suture-ligation group was 127.1 ±7.95 minutes and intraoperative blood loss in group A was 62.06 ± 7.34 and in group B was 75.84± 9.21. Temporary RLN injury was detected in 3 patients (3%) in group A and in 5 patients in group B (5%). No permanent hypoparathyroidism was seen in group A patients but in one patient (1%) of group B, transient hypoparathyroidism occurred in 2 patients (2%) of both groups. The amount of fluid drained in group A was 54.16 ±9.21 and 66.28 ±8.99 in group B. Conclusion: The use of the Ligasure sealing system in total thyroidectomy is proved safe and effective in reducing the operative time, intraoperative blood loss together with reduction in postoperative fluid drainage. Owing to the ability to reduce energy spread profile, use of Ligasure sealing system is accompanied with better outcome regarding the function of laryngeal nerves and parathyroids.

Published in Journal of Surgery (Volume 4, Issue 3-1)

This article belongs to the Special Issue Surgical Infections and Sepsis

DOI 10.11648/j.js.s.2016040301.17
Page(s) 34-38
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2016. Published by Science Publishing Group

Keywords

Ligasure, Suture-Ligation, Total Thyroidectomy, Outcome

References
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Cite This Article
  • APA Style

    Wael AlJuraibi, Mohamed Rifaat Ahmed, Aly Saber. (2016). Use of Ligasure Sealing Versus Conventional Suture - Ligation in Total Thyroidectomy. Journal of Surgery, 4(3-1), 34-38. https://doi.org/10.11648/j.js.s.2016040301.17

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    ACS Style

    Wael AlJuraibi; Mohamed Rifaat Ahmed; Aly Saber. Use of Ligasure Sealing Versus Conventional Suture - Ligation in Total Thyroidectomy. J. Surg. 2016, 4(3-1), 34-38. doi: 10.11648/j.js.s.2016040301.17

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    AMA Style

    Wael AlJuraibi, Mohamed Rifaat Ahmed, Aly Saber. Use of Ligasure Sealing Versus Conventional Suture - Ligation in Total Thyroidectomy. J Surg. 2016;4(3-1):34-38. doi: 10.11648/j.js.s.2016040301.17

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  • @article{10.11648/j.js.s.2016040301.17,
      author = {Wael AlJuraibi and Mohamed Rifaat Ahmed and Aly Saber},
      title = {Use of Ligasure Sealing Versus Conventional Suture - Ligation in Total Thyroidectomy},
      journal = {Journal of Surgery},
      volume = {4},
      number = {3-1},
      pages = {34-38},
      doi = {10.11648/j.js.s.2016040301.17},
      url = {https://doi.org/10.11648/j.js.s.2016040301.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2016040301.17},
      abstract = {Introduction: Effective vessel haemostasis can be achieved by suture knot tying technique or newer techniques of vessel haemostasis like ligasure as an alternative bipolar surgical diathermy system. Various diathermy techniques have been proposed to reduce intraoperative blood loss in surgery and the new electrothermal bipolar tissue sealing system (Ligasure) has been applied in various specialties of surgery. The objective of this randomized study was to compare the outcome of ligasure versus conventional clamping and tie in total thyroidectomy for benign thyroid diseases. Patients and Methods: A total of 200 patients diagnosed to have bilateral BMNG were subjected to primary total thyroidectomy and divided into two main groups Ligasure (L) and Suture-Ligation (SL). For detection of laryngeal nerves status, vocal cords were checked immediately postoperatively by laryngoscope and at the day 10 of postoperative period to assess the status of both laryngeal nerves. The function of the parathyroids was checked by detecting the serum calcium concentration and parathyroid hormone level. The following parameters were measured to compare the effect of ligasure versus conventional suture-ligation technique in decreasing the operative blood loss, operative time, securing laryngeal nerves and parathyroids, postoperative drainage and postoperative wound infection. Results: There was no statistical difference between the two groups regarding age, sex and body mass index and also there was no operative mortality. As regard the operative time, in ligasure group it was 115.54 ±15.35 minutes while in suture-ligation group was 127.1 ±7.95 minutes and intraoperative blood loss in group A was 62.06 ± 7.34 and in group B was 75.84± 9.21. Temporary RLN injury was detected in 3 patients (3%) in group A and in 5 patients in group B (5%). No permanent hypoparathyroidism was seen in group A patients but in one patient (1%) of group B, transient hypoparathyroidism occurred in 2 patients (2%) of both groups. The amount of fluid drained in group A was 54.16 ±9.21 and 66.28 ±8.99 in group B. Conclusion: The use of the Ligasure sealing system in total thyroidectomy is proved safe and effective in reducing the operative time, intraoperative blood loss together with reduction in postoperative fluid drainage. Owing to the ability to reduce energy spread profile, use of Ligasure sealing system is accompanied with better outcome regarding the function of laryngeal nerves and parathyroids.},
     year = {2016}
    }
    

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  • TY  - JOUR
    T1  - Use of Ligasure Sealing Versus Conventional Suture - Ligation in Total Thyroidectomy
    AU  - Wael AlJuraibi
    AU  - Mohamed Rifaat Ahmed
    AU  - Aly Saber
    Y1  - 2016/06/04
    PY  - 2016
    N1  - https://doi.org/10.11648/j.js.s.2016040301.17
    DO  - 10.11648/j.js.s.2016040301.17
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 34
    EP  - 38
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.s.2016040301.17
    AB  - Introduction: Effective vessel haemostasis can be achieved by suture knot tying technique or newer techniques of vessel haemostasis like ligasure as an alternative bipolar surgical diathermy system. Various diathermy techniques have been proposed to reduce intraoperative blood loss in surgery and the new electrothermal bipolar tissue sealing system (Ligasure) has been applied in various specialties of surgery. The objective of this randomized study was to compare the outcome of ligasure versus conventional clamping and tie in total thyroidectomy for benign thyroid diseases. Patients and Methods: A total of 200 patients diagnosed to have bilateral BMNG were subjected to primary total thyroidectomy and divided into two main groups Ligasure (L) and Suture-Ligation (SL). For detection of laryngeal nerves status, vocal cords were checked immediately postoperatively by laryngoscope and at the day 10 of postoperative period to assess the status of both laryngeal nerves. The function of the parathyroids was checked by detecting the serum calcium concentration and parathyroid hormone level. The following parameters were measured to compare the effect of ligasure versus conventional suture-ligation technique in decreasing the operative blood loss, operative time, securing laryngeal nerves and parathyroids, postoperative drainage and postoperative wound infection. Results: There was no statistical difference between the two groups regarding age, sex and body mass index and also there was no operative mortality. As regard the operative time, in ligasure group it was 115.54 ±15.35 minutes while in suture-ligation group was 127.1 ±7.95 minutes and intraoperative blood loss in group A was 62.06 ± 7.34 and in group B was 75.84± 9.21. Temporary RLN injury was detected in 3 patients (3%) in group A and in 5 patients in group B (5%). No permanent hypoparathyroidism was seen in group A patients but in one patient (1%) of group B, transient hypoparathyroidism occurred in 2 patients (2%) of both groups. The amount of fluid drained in group A was 54.16 ±9.21 and 66.28 ±8.99 in group B. Conclusion: The use of the Ligasure sealing system in total thyroidectomy is proved safe and effective in reducing the operative time, intraoperative blood loss together with reduction in postoperative fluid drainage. Owing to the ability to reduce energy spread profile, use of Ligasure sealing system is accompanied with better outcome regarding the function of laryngeal nerves and parathyroids.
    VL  - 4
    IS  - 3-1
    ER  - 

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Author Information
  • Department of otolaryngology & Head and neck surgery, Al Hayat National hospital, Jazan , Saudi Arabia

  • Department of Otolaryngology, faculty of medicine, Suez Canal University,Ismailia, Egypt

  • Port-Fouad general Hospital, Port-Fouad, Egypt

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