Aim: This study aimed at comparing the safety of the focus harmonic scalpel (HS) during conventional 
“open" thyroidectomy (CT) versus knot tying technique (KT). 
Methods: Forty-six patients scheduled for conventional total thyroidectomy (TT) were included in the study 
and randomly assigned to TT with the use of HS (HS group 23 patients) or with knot tying technique (KT 
group 23 patients).
Results: Mean operative time was significantly shorter in the HS group (P < 0.001). There were reduction in 
the post-operative complications. The number of patients in whom a drain was used was lower in HS than 
CT groups (10 vs 23, P < 0.001= S). The total drainage fluid volume was lower in HS than in CT (40.4 ±35.4 
vs 46.1 ± 40.1ml respectively, P= NS).
Conclusions: HS is a safe alternative to KT, allowing for a significant reduction of operative time without 
increasing complications rate.