Thyroidectomy is one of the most frequently performed procedures in the field of head and neck surgery worldwide.
Thyroid surgery is performed by various types of surgeons, including head and neck surgeons, endocrine surgeons, oncologic surgeons, and general surgeons.
Safe thyroid surgery requires meticulous attention to hemostasis and careful control of bleeding while preserving critical structures such as the recurrent laryngeal nerve.
The thyroid gland has an abundant blood supply; prompt hemostasis is essential to avoid intraoperative bleeding, maintain a clear surgical field to prevent injury to vital structures such as the parathyroid glands or recurrent laryngeal nerve, and reduce related postoperative complications.
Hemostasis is a key factor that determines the incidence of other complications and whether the operative time is prolonged, thereby influencing the length of hospitalization and overall medical costs.
Currently, various methods are used clinically to achieve surgical hemostasis, including ligation and suturing (using sutures, clips, and staplers), electrocautery (monopolar and bipolar electrosurgery), ultrasonic coagulation, and electrothermal vessel sealing.
Electrosurgical devices rely on thermal energy to denature proteins; however, the lateral spread of heat within the surgical field may damage surrounding critical structures. In recent years, there has been an urgent need to explore new technologies with reduced thermal diffusion effects in order to minimize intraoperative complications and shorten operative time.
Today, we would like to introduce our company's Ultrasonic Scalpel, a surgical device designed to provide efficient cutting and coagulation with minimal thermal spread.
This article aims to discuss the differences in clinical surgical outcomes between the use of ultrasonic scalpels and conventional ligation techniques in thyroid surgery.
The ultrasonic scalpel utilizes mechanical energy generated by ultrasonic vibrations at frequencies of up to 55,000 Hz to achieve vessel sealing by disrupting hydrogen bonds and protein bonds within tissues and blood vessels, thereby forming a coagulum within the vessel lumen.
Its relatively low operating temperature (50–100 ℃) minimizes heat conduction to adjacent tissues, thereby reducing the risk of thermal injury. In addition, the device does not transmit any form of electrical current through the patient's body during operation.
The Ultrasonic Scalpel integrates both hemostatic and cutting functions into a single device, thereby avoiding the time consumption associated with frequent switching and handling of multiple instruments.
The success of thyroid surgery mainly depends on several critical factors: achieving adequate hemostasis to prevent potentially life-threatening hemorrhage, maintaining a clear surgical field to facilitate tissue dissection, and preserving vital structures, especially the recurrent laryngeal nerve and parathyroid glands. Based on these clinical requirements, the TM-sure scissor-style ultrasonic scalpel manufactured by our company is designed to effectively meet surgeons' needs.
Transient hypocalcemia observed after total thyroidectomy (TT) is considered to be associated with injury to the parathyroid glands, which are closely attached to the thyroid gland and share part of its blood supply. We speculate that the use of an ultrasonic scalpel may facilitate dissection along a plane farther away from the parathyroid capsule, thereby reducing the likelihood of compromising its blood supply.
As a safe, effective, and efficient alternative to conventional thyroidectomy techniques, the ultrasonic scalpel offers significant clinical advantages.
Its primary benefit lies in simplifying the surgical procedure by eliminating the need for metallic clips and suture ligation while still achieving reliable hemostasis. Clinical surgeons who have experience with both ultrasonic scalpels and conventional electrosurgical devices generally report that, in similar procedures, the use of an ultrasonic scalpel significantly reduces operative time, intraoperative blood loss, and postoperative hospital stay.
In sutureless open and endoscopic-assisted thyroid surgery, the operative field is often limited due to the anatomical characteristics of the neck. Therefore, maintaining a clear and bloodless surgical field is of critical importance.
One important point should be noted: according to feedback from clinical surgeons during procedures, recurrent laryngeal nerve (RLN) palsy following total thyroidectomy (TT) is an extremely rare complication.
Clinical evidence has demonstrated that the ultrasonic scalpel causes less thermal injury to surrounding tissues compared with conventional electrocautery hemostasis techniques. However, regarding the incidence of recurrent laryngeal nerve dysfunction (RLND), no significant difference has been observed between ultrasonic devices and traditional electrosurgical instruments.
Therefore, when using this device near critically important anatomical structures such as the RLN, meticulous and cautious operation remains essential.
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