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Haemostatic devices in parotid surgery: a systematic review

Published online by Cambridge University Press:  23 August 2021

L Allen ,
C MacKay ,
M H Rigby ,
J Trites  and
S M Taylor
L Allen
Affiliation:
Faculty of Medicine, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada
C MacKay
Affiliation:
Division of Otolaryngology – Head & Neck Surgery, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada
M H Rigby
Affiliation:
Division of Otolaryngology – Head & Neck Surgery, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada
J Trites
Affiliation:
Division of Otolaryngology – Head & Neck Surgery, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada
S M Taylor*
Affiliation:
Division of Otolaryngology – Head & Neck Surgery, QEII Health Sciences Centre, Dalhousie University, Halifax, Canada
*
Author for correspondence: Dr S M Taylor, Division of Otolaryngology – Head and Neck Surgery, Dalhousie University, Dickson Building, QEII Health Sciences Centre, 5820 University Avenue, HalifaxB3H 2Y9, Canada E-mail: smarktaylor@eastlink.ca
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Abstract

Objective

The Harmonic Scalpel and Ligasure (Covidien) devices are commonly used in head and neck surgery. Parotidectomy is a complex and intricate surgery that requires careful dissection of the facial nerve. This study aimed to compare surgical outcomes in parotidectomy using these haemostatic devices with traditional scalpel and cautery.

Method

A systematic review of the literature was performed with subsequent meta-analysis of seven studies that compared the use of haemostatic devices to traditional scalpel and cautery in parotidectomy. Outcome measures included: temporary facial paresis, operating time, intra-operative blood loss, post-operative drain output and length of hospital stay.

Results

A total of 7 studies representing 675 patients were identified: 372 patients were treated with haemostatic devices, and 303 patients were treated with scalpel and cautery. Statistically significant outcomes favouring the use of haemostatic devices included operating time, intra-operative blood loss and post-operative drain output. Outcome measures that did not favour either treatment included facial nerve paresis and length of hospital stay.

Conclusion

Overall, haemostatic devices were found to reduce operating time, intra-operative blood loss and post-operative drain output.

Keywords

Facial ParalysisLength Of StayDissectionSalivary GlandsHemostaticsCautery
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 10 , October 2021 , pp. 848 - 854
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr S M Taylor takes responsibility for the integrity of the content of the paper

References

Laurie, SA, Licitra, L. Systemic therapy in the palliative management of advanced salivary gland cancers. J Clin Oncol 2006;24:2673–8CrossRefGoogle ScholarPubMed
Guzzo, M, Locati, LD, Prott, FJ, Gatta, G, McGurk, M, Licitra, L. Major and minor salivary gland tumors. Crit Revs Oncol Hematol 2010;74:134–48CrossRefGoogle ScholarPubMed
Spiro, RH. Salivary neoplasms: overview of a 35-year experience with 2,807 patients. Head Neck Surg 1986;8:177–84CrossRefGoogle ScholarPubMed
Metternich, FU, Sagowski, C, Wenzel, S, Jäkel, T, Leuwer, R, Koch, U. Preliminary results for superficial parotidectomy using the ultrasonically activated scalpel (Ultracision Harmonic Scalpel). Laryngorhinootologie 2003;82:514–9Google Scholar
Blankenship, DR, Gourin, CG, Porubsky, EA, Porubsky, ES, Klippert, FN, Whitaker, EG et al. Harmonic scalpel versus cold knife dissection in superficial parotidectomy. Otolaryngol Head Neck Surg 2004;131:397–400CrossRefGoogle ScholarPubMed
Muhanna, N, Peleg, U, Schwartz, Y, Shaul, H, Perez, R, Sichel, JY. Harmonic scalpel assisted superficial parotidectomy. Ann Otol Rhinol Laryngol 2014;123:636–40CrossRefGoogle ScholarPubMed
Monfared, A, Terris, DJ. Harmonic scalpel tonsillectomy: technical considerations. Oper Tech Otolaryngol Head Neck Surg 2002;13:155–7CrossRefGoogle Scholar
Hahn, CH, Sørensen, CH. LigaSure small jaws versus cold knife dissection in superficial parotidectomy. Eur Arch Otorhinolaryngol 2013;270:1489–92CrossRefGoogle ScholarPubMed
Hammad, AY, Deniwar, A, Al-Qurayshi, Z, Mohamed, HE, Rizwan, A, Kandil, E. A prospective study comparing the efficacy and surgical outcomes of Harmonic Focus Scalpel versus LigaSure Small Jaw in thyroid and parathyroid surgery. Surg Innov 2016;23:486–9CrossRefGoogle ScholarPubMed
Lang, BH, Ng, SH, Lau, LL, Cowling, BJ, Wong, KP. A systematic review and meta-analysis comparing the efficacy and surgical outcomes of total thyroidectomy between harmonic scalpel versus ligasure. Ann Surg Oncol 2013;20:1918–26CrossRefGoogle ScholarPubMed
Hwang, SO, Jung, JH, Park, HY, Kim, WW. A prospective, randomized study between the Small Jaw® and the Harmonic Focus® in open thyroidectomy. Otolaryngol Head Neck Surg 2014;150:943–8CrossRefGoogle Scholar
Cordón, C, Fajardo, R, Ramírez, J, Herrera, MF. A randomized, prospective, parallel group study comparing the Harmonic Scalpel to electrocautery in thyroidectomy. Surgery 2005;137:337–41CrossRefGoogle Scholar
Shemen, L. Thyroidectomy using the harmonic scalpel: analysis of 105 consecutive cases. Otolaryngol Head Neck Surg 2002;127:284–8CrossRefGoogle ScholarPubMed
Wiatrak, BJ, Willging, JP. Harmonic scalpel for tonsillectomy. Laryngoscope 2002;112:14–6CrossRefGoogle ScholarPubMed
Dean, A, Alamillos, F, Centella, I, García–Álvarez, S. Neck dissection with the harmonic scalpel in patients with squamous cell carcinoma of the oral cavity. J Craniomaxillofac Surg 2014;42:84–7CrossRefGoogle ScholarPubMed
Pons, Y, Gauthier, J, Clément, P, Conessa, C. Ultrasonic partial glossectomy. Head Neck Oncol 2009;1:21CrossRefGoogle ScholarPubMed
Walker, RA, Syed, ZA. Harmonic scalpel tonsillectomy versus electrocautery tonsillectomy: a comparative pilot study. Otolaryngol Head Neck Surg 2001;125:449–55CrossRefGoogle ScholarPubMed
Morgenstein, SA, Jacobs, HK, Brusca, PA, Consiglio, AR, Donzelli, J, Jakubiec, JA et al. A comparison of tonsillectomy with the harmonic scalpel versus electrocautery. Otolaryngol Head Neck Surg 2002;127:333–8CrossRefGoogle ScholarPubMed
Ortega, J, Sala, C, Flor, B, Lledo, S. Efficacy and cost-effectiveness of the UltraCision® harmonic scalpel in thyroid surgery: an analysis of 200 cases in a randomized trial. J Laparoendosc Adv Surg Tech 2004;14:9–12CrossRefGoogle Scholar
Ecker, T, Carvalho, AL, Choe, JH, Walosek, G, Preuss, KJ. Hemostasis in thyroid surgery: harmonic scalpel versus other techniques—a meta-analysis. Otolaryngol Head Neck Surg 2010;143:17–25CrossRefGoogle ScholarPubMed
Deganello, A, Meccariello, G, Busoni, M, Parrinello, G, Bertolai, R, Gallo, O. Dissection with harmonic scalpel versus cold instruments in parotid surgery. B-ent 2014;10:175–8Google ScholarPubMed
Pons, Y, Gauthier, J, Ukkola-Pons, E, Clément, P, Roguet, E, Poncet, JL et al. Comparison of LigaSure vessel sealing system, harmonic scalpel, and conventional hemostasis in total thyroidectomy. Otolaryngol Head Neck Surg 2009;141:496–501CrossRefGoogle ScholarPubMed
Salami, A, Dellepiane, M, Bavazzano, M, Crippa, B, Mora, F, Mora, R. New trends in head and neck surgery: a prospective evaluation of the Harmonic Scalpel. Med Sci Monit 2008;14:1–5Google ScholarPubMed
Sebag, F, Fortanier, C, Ippolito, G, Lagier, A, Auquier, P, Henry, JF. Harmonic scalpel in multinodular goiter surgery: impact on surgery and cost analysis. J Laparoendosc Adv Surg Tech 2009;19:171–4CrossRefGoogle ScholarPubMed
Yildirim, O, Umit, T, Ebru, M, Bulent, U, Belma, K, Betul, B et al. Ultrasonic harmonic scalpel in total thyroidectomies. Adv Ther 2008;25:260–5CrossRefGoogle ScholarPubMed
Koutsoumanis, K, Koutras, AS, Drimousis, PG, Stamou, KM, Theodorou, D, Katsaragakis, et al. The use of a harmonic scalpel in thyroid surgery: report of a 3-year experience. Am J Surg 2007;193:693–6CrossRefGoogle ScholarPubMed
Jackson, LL, Gourin, CG, Thomas, DS, Porubsky, ES, Klippert, FN, Terris, DJ. Use of the harmonic scalpel in superficial and total parotidectomy for benign and malignant disease. Laryngoscope 2005;115:1070–3CrossRefGoogle ScholarPubMed
Polacco, MA, Pintea, AM, Gosselin, BJ, Paydarfar, JA. Parotidectomy using the Harmonic scalpel: ten years of experience at a rural academic health center. Head Face Med 2017;13:8CrossRefGoogle Scholar
Yang, X, Yu, Y, Li, D, Dong, L. Comparison of complications in parotid surgery with Harmonic scalpel versus cold instruments. J Craniofac Surg 2017;28:e342–4CrossRefGoogle ScholarPubMed