Background and Objectives: Thyroid disorders are frequently encountered at the surgical outpatient department. Harmonic scalpel uses high-frequency mechanical energy to cut and coagulate tissues and vessels simultaneously. In this study, we evaluated the efficiency, safety, and the impact on the surgical outcome of the utilization of harmonic scalpel during total thyroidectomy.

Methods: Out of 60 patients included in the study, 30 underwent total thyroidectomy using conventional methods including monopolar/ bipolar cautery and 30 using harmonic scalpel. Post-operative transient hypocalcemia, recurrent laryngeal nerve palsy, drain output and total duration of surgery were compared among the groups.

Results: Both the groups had comparable age and sex ratios. The duration of surgery was significantly      (p < 0.05) shorter in the harmonic scalpel (97.5±13.75 min) than in the conventional technique group (131.5±21.21 min). Post-operative drain outputat 24 and 48 hours in harmonic scalpel group (23±8.8 ml, 34±8.0 ml) was significantly lower than conventional group (30±5.8ml, 46.33±9.18 ml)(p <0.05). The incidence of transient hypocalcemia was significantly more (p<0.05) in conventional (n= 6) group as compared to harmonic group (n=1). Hoarseness of voice associated with recurrent laryngeal nerve injury was observed in three patients in conventional group. Hoarseness of voice was not observed in patients of harmonic scalpel group.

Conclusion: Use of harmonic scalpel in thyroidectomy is safe and effective and lowers incidence of postoperative complications, shorter operative time, and lower drain output.

Thyroidectomy; Harmonic Scalpel; Electro Cautery.