İsmail Yaman, Hayrullah Derici

Balıkesir Üniversitesi Tıp Fakültesi Genel Cerrahi A.D.

Keywords: Thyroidectomy, LigaSure, recurrent laryngeal nerve, hypoparathyroidism

Abstract

Introduction: The traditional method in thyroidectomy is time consuming, the application of electrocautery in this method can cause the dissemination of heat in neighbouring tissues. In order to shorten and ease the surgeries, many appliances have been used in bleeding control. LigaSure is the most widespread current electrothermal vessel sealing device. In the literature many different results have been reported.
It was aimed to compare the causes to which total thyroidectomy is applied in the conventionel method with the cases thyroidectomy is applied by using LigaSure.
Material and Method: The files of the patients who had been applied thyroidectomy between October 2009 and September 2011 have been analysed in two groups: one is the patients who had their surgeries with the traditional method, the other is the ones who had their surgeries by using LigaSure.
Results: In the LigaSure group among the patients below 45, the usage of anti-hemorrhagic agents was considerably high, average surgery time was considerably short. Temporary recurrent laryngeal nerve paralysis in LigaSure group was considerably high. Though the proportions of temporary hipoparatiroidi and seroma in the LigaSure group was high, the difference was not meaningful statistically.
Discussion: It was obtained in our research that the usage of LigaSure shortened the surgeries 6.9 minutes. We interprete that despite being considerable, the difference was below the expectations as a result of using non-cutting, old type LigaSure.
In the group Ligasure was used, the rise in the recurrent laryngeal neural paralysis might have been due to its usage close to the nerves. In the surgery attempts after reaching this result we’re using routine knots in this area.
We think using more anti-hemorrhagic in LigaSure group stems from our using anti-hemorragic agent as a routine in the first period of the appliance and using the device in Berry Ligament, as well.
These results arise the idea that LigaSure causes effective and reliable hemostasis, shortens the surgery but when used near vital tissues such as recurrent laryngeal nerve, it can increase the risk of complications.