Impact of the Harmonic Scalpel hemostasis in Total thyroidectomy Sadq G Kadem & Raheem S Balasim Basrah Journal Of Surgery Bas J Surg, December, 22, 2016 IMPACT OF THE HARMONIC SCALPEL HEMOSTASIS IN TOTAL THYROIDECTOMY IN COMPARISON WITH CONVENTIONAL HEMOSTATIC TECHNIQUE Sadq Ghaleb Kadem * & Raheem Sharhan Balasim @ * MB,ChB, FICMS. @ MB,ChB, FICMS, Department of Surgery, Al-Shiffa General Hospital, Basrah, IRAQ. Abstract Traditional haemostatic technique in thyroidectomy may cause some damages to surrounding tissues and it is time consuming. It is believed that these damages and the time can be reduced using ultrasonic dissector devices like Harmonic Scalpel. In this study, we investigate the benefits of harmonic Scalpel haemostasis (HS) versus conventional haemostatic techniques (CT) in total thyroidectomy. Analysis of patient’s data was done for cases with total thyroidectomies performed between 2011and 2015 by the same surgeons using either the conventional technique (Clamp and Tie technique) or the harmonic scalpel for haemostasis. Gender, age, preoperative clinical information, histopathology results,and procedure type were analyzed. and according to the type of haemostatic techniques the collected patient’s data was divided in to two groups; conventional group (CT group) in which the haemostasis was done with Clamp and Tie technique and harmonic scalpel group (HS group) in which the haemostasis was done with Harmonic Scalpel (Sonicbeat Olympus). The outcome and the complications of the both procedures were analyzed statistically and compared. The use of harmonic scalpel in total thyroidectomy significantly decreases mean operative time by (-37.635 min) 60.49±7.78 SD for HS group vs 98.13±14.165 SD for CT group with very significant P-value (0.0000). Statistical significant difference in the mean volume of postoperative drainage in (ml) through redivac drain observed between the two groups; 63.02±19.91SD for HS group and 72.50±22.79 SD for CT group with significant P-value (0.0000). There were no significant difference in the other parameters of the outcome and complications after total thyroidectomy in both groups. It is concluded from this study that main impact of harmonic scalpel in total thyroidectomy is the significant reduction in operative time and its use is safe and not associated with increase in the rate of the complications. Introduction hyroidectomy is one of the frequent operation done over the world. In 952 AD, the first goiter excision had been done by Islam’s medieval surgeon from Andalusia, Abu al-Qasim alzahrawee as mentioned in his book ‘’ Al-Tasrif ’’. A thousand years later, Theodor Kocher ‘‘Father of Thyroid Surgery’’ describes a safe procedure for thyroidectomy and from that time till now this procedure still valid and considered as a gold standard procedure for thyroidectomy 1 . In recent years and despite the revolution in modern surgical procedures toward minimal invasiveness, the original conventional (Theodor Kocher) thyroidectomy remain the only widely accepted procedure and the only accepted changes on this procedure is the method of haemostasis 2-4 . The methods of haemostasis and ligation of blood vessels during conventional thyroidectomy involves using either frequent clamp and tie with sutures, metal clips or electrocautary, these conventional methods are time consuming and may be associated with complications; frequent clamp and tie may injure the nearby vital T 63  Bas J Surg, December, 22, 2016