Early Experience with LigaSure Thyroidectomy in a Nigeria Teaching Hospital

Abstract

Background: The principles of safe and efficient thyroid surgery had been established and the technique has remained the same for over the century without any major significant changes. The introductions of electrosurgical devices constitute a major shift in the technique of thyroid surgery.

Objective: We present our early experience with the use of LIGASURE vessel sealing system for the procedure of thyroidectomy.

Materials and methods: This was a quasi-experimental study comparing outcome of LigaSure thyroidectomy in a prospective nonrandomized cohort with another retrospective cohort of preintervention clamp-and-tie thyroidectomy.

Results: A total of 30 patients with a clinical diagnosis of goiter were recruited into the study. There were two males and 28 females with a mean age of 42.6 years. Diagnosis was simple multinodular goiter 24 (80%), controlled toxic nodular goiter 3 (10%), grave disease 1 (3.3%), and multinodular goiter with retrosternal extension 2 (6.7%). The mean thyroid weight was 121.0 g. The mean duration of surgery was 59 min compared to 128 min for traditional technique (P < 0.01). The mean blood loss of 116 ml was significantly less than 328 ml following the traditional technique (P < 0.01). Mean duration of hospital stay was 1.9 days, compared to 3.55 days in the traditional technique group (P = 0.02). Troubling postoperative complications of change in voice quality occurred in only one patient (3.3%).

Conclusion: LigaSure thyroidectomy was found to be easier and faster to carry out with no learning curve and easy to learn and adapt.

Keywords: Goiter; LigaSure thyroidectomy; Nigeria; sutureless thyroidectomy.

Figure 1

Raising the superior myocutanous flap with LigaSure

Figure 2

Ligating the superior thyroid pedicle with LigaSure

Figure 3

Completing excision of thyroid gland after dissection with LigaSure