Impact of the use of vessel sealing or harmonic scalpel on intra-hospital outcomes and the cost of thyroidectomy procedures

Abstract

Objectives: To analyze the operative time, length of hospitalizationand cost, as well as the bleeding and pain observed during thepostoperative period, of thyroidectomy procedures using vesselsealing, harmonic scalpel or the conventional technique. Methods:Retrospective analysis of thyroidectomies performed between 2007and 2010 using either the conventional technique or minimallyinvasive techniques involving vessel sealing or a harmonic scalpel.Gender, age, primary diagnosis and procedure type were analyzed.The outcomes analyzed included the length of the procedure, lengthof hospital stay, need for blood product transfusions, pain andcost of hospitalization. The findings were based on a significancelevel of 5%, and statistical analyses were performed using the Rsoftware. Results: The use of the vessel sealing increased theduration of the surgery by approximately 47 minutes compared tothe conventional technique (p<0.001), and the use of the harmonicscalpel decreased the duration of the surgery by approximately 32minutes compared to the conventional technique (p<0.001). Nostatistically significant difference was found between the groupsregarding the use of blood products and pain score. Proceduresinvolving vessel sealing or a harmonic scalpel cost more thanthose using the conventional technique. Conclusion: The use ofharmonic scalpel was favorable in terms of reducing the surgicaltime, but there was no reduction in hospitalization time. Thecost of the procedure was higher than that of the conventionaltechnique. The use of vessel sealing offered no advantages interms of the outcomes assessed, and the cost of the procedurewas greater than that of the conventional technique.

Keywords

• Thyroidectomy
• Health economics
• Cost-effectiveness evaluation
• Technology
• high-cost