Background: Thyroid gland is a highly vascular organ. So, doing thyroidectomy requires good hemostasis even for the small blood vessels either through conventional tie technique which is time-consuming or through the use of a harmonic scalpel.
Objective: To evaluate the real benefits of the Harmonic Scalpel in total thyroidectomies when compared with conventional ligation, in terms of operative time, postoperative drainage, and complications.
Patients and methods: This randomized, prospective observational study was carried out at Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt.  Written informed consents were obtained from Seventy-six patients with benign goiter disorders who were scheduled for elective total thyroidectomy during a period from August 2019 to October 2020. Thirty eight patients were submitted to conventional thyroidectomy (group A), and thirty eight underwent thyroidectomy using a harmonic scalpel (group B).
Results: There was no statistical difference between the two groups as regards demographic data, hospital stay, recurrent laryngeal nerve injury, and hypocalcemia, but there was a statistically significant difference as regards operative time (76.9±15.1 min in group A versus 89.23±17.68 in group B) and drainage volume (111.75±56.57 mls in group A versus 89 ± 16.21 mls in group B).
Conclusion: Harmonic scalpel for total thyroidectomy is a better choice compared to the conventional tie technique as regards operative time and postoperative drainage volume.