Abstract
Introduction: Thyroidectomy could be considered as the commonest neck surgery in surgical practice. Proper thyroidectomy requires careful and meticulous devascularization of the gland with preservation of surrounding important structures. Haemostasis during thyroidectomy achieved by suture ligation, electro-cautery or vessel sealing devices. The traditional knot-tying method requires carful dissection which is time consuming and may lead to injury of laryngeal nerves or impairment of blood supply to parathyroid glands. Bipolar electro-cautery has precise delivery of electric current between its tips with no or limited thermal dispersion to surrounding structures. Advanced vessel sealing devices not always available and requires special disposable handles which increases the coast.
Aim: This prospective comparative study aims at evaluating the outcome of thyroidectomy using bipolar in comparison with traditional thyroidectomy using suture ligation.
Method: Total thyroidectomy was carried out on 60 patients, equally divided in two groups each 30 patients. First group, haemostasis has been achieved by suture ligation. In the second group bipolar electro-cautery has been used.
Result: In group A (knot-tying) mean operative time was 124.7±5.2 min and estimated blood loss about 101±15.9 ml with significant P value in comparison with group B (bipolar) in which mean operative time was 103.9±7.8 min and blood loss about 80±16.2 ml. Significant P value regarding post operative pain but non significant regarding operative and post operative complications.
Conclusion: Bipolar electro-cautery is a simple and effective in thyroidectomy with less operative time, blood loss and without increased incidence of complications.
Key words: thyroidectomy; bipolar; suturless.