The use of harmonic scalpel versus knot tying for conventional open thyroidectomy: results of a prospective randomized study

Purpose. We evaluated the safety and cost-effectiveness of the harmonic scalpel (HS) during conventional open thyroidectomy (CT). Materials and methods. Two hundred patients scheduled for conventional total thyroidectomy (TT) were included in the study and randomly assigned to TT with the use of HS (HS group) or with knot tying technique (KT group). Results. Mean operative time was significantly shorter in the HS group (P < 0.001), as well as the total operative room occupation time (P < 0.001). The cost of the disposable materials is significantly higher in the HS group (420.1 ± 23.2 vs 137.8 ± 25.3 euros; P < 0.001). Conversely, drugs, personnel and operative room charges were significantly higher in KT group patients (P < 0.001). Overall, no significant difference was found between the two groups concerning the charges of the hospitalisation (P = NS). Conclusions. HS is a safe alternative to KT, allowing for a significant reduction of operative time without increasing complications rate and overall costs and probably better utilization of health resources.