Thyroid surgery has evolved and one of the biggest advances has been the introduction of the Harmonic Scalpel (Ethicon Endosurgery, Johnson & Johnson).
The Harmonic Scalpel uses ultracision technology originally developed in the United States to assist gynaecological surgery.
The Harmonic Scalpel device utilises a piezo-electric crystal to turn electricity into motion at the tip of the active blade which vibrates at 55,000 Hz. This rapid motion causes tissue between the blades - including blood vessels to be sealed and then divided in a few seconds.
The advantages of this technology are compared to standard techniques of electric cautery devices (diathermy) and are:
1. Reduced bleeding
2. Less heat in the tissues - potentially heat can be damaging to surrounding structures
3. Avoidance of electricity passing through the patient
As a result of these advantages as a thyroid surgeon I find:
1. Less bleeding means greater vison of delicate structures in the neck
2. Easier to protect the recurrent laryngeal nerve
3. Easier to preserve the parathyroid glands
4. Much faster as I can divide structures very rapidly
All of this hopefully translates into a better outcome for a patient undergoing thyroid surgery. There are a number of studies now available including some randomised controlled trials comparing thryoid surgery with and without use of the Harmonic Scalpel which clear show these benefits.
If you would like to watch a video of me undertaking thyroid surgery with the Harmonic Focus device please click on the link below.
Mr Mclaren performing thyroid surgery with Harmonic Focus device
Thyroid and Minimal Access Thyroid Surgery
