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Article
The effect of 2 different techniques in second stage implant surgery

Author: (1). CABMS ,DSB -Hassanien Al. AJumail
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2019 Volume: 31 Issue: 1 Pages: 25-30
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Dental implant is one of the most important options for teeth replacement. In two stage implant surgery, a few options could be used for uncovering implants, scalpel and laser are both considered as effective methods for this purpose.The Aim of the study: To compare soft tissue laser and scalpel for exposing implant in 2nd stage surgery in terms of the need for anesthesia, duration of procedure and pain level assessment at day 1 and day 7 post operatively using visual analogue scale .Materials and methods: Ten patients who received bilateral implants participated after healing period completed, gingival depth over each implant was recorded and then implant(s) were exposed by either scalpel or laser with determination for the need of anesthesia. Duration of the procedure was calculated in each case and post-operative pain was assessed by Visual analogue scale at day 1 and day 7.Results: Statistically significant difference in the need of anesthesia was found. A non-significant difference in the duration of the operation was found between the two methods. Non-significant difference was found between the two methods regarding post-operative pain at day 1, with the day 7 scores "no pain or zero pain score" in all the cases by the two methods. A directional significant correlation was found between depth of the gingival tissue over the implants and duration of the procedures regardless of the method used.Conclusion: diode laser can be used effectively for uncovering implants, providing both the dentist and the patient with additional advantages over the conventional methods. Although there was insignificant difference in pain scoring, however implant exposure by laser was more preferred by the patients.

Keywords

laser --- scalpel --- implant


Article
Harmonic versus electrocautery in the dissection of gall bladder in laparoscopic cholecystectomy
دراسة مقارنة بين القاطع الصوتي والكهربائي في عملية رفع المرارة بالمنظار الجراحي

Authors: Muna M. Ahmad منى منير أحمد --- Samer Alsaffar سمير الصفار --- Emad Tahir عماد طاهر --- Nashwan K. Mahjob نشوان قحطان محجوب
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2013 Volume: 39 Issue: 2 Pages: 107-112
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACTObjective: To demonstrate the efficiency and safety of Harmonic scalpel in comparison with electrocautery for gallbladder dissection and hemostasis in laparoscopic cholecystectomy. Patients and methods: A prospective comparative, study was done at Al-Jamhori Teaching Hospital in Mosul, during the period from 1st of January 2010 to 1st of January 2012. Three hundred and twenty patients underwent laparoscopic cholecystectomy, the following criteria were applied for selection: they had chronic cholecystitis, no complaint at time of operation, age between 25 to 50 years, normal body weight, with American Score of Anesthesia (ASA) of 1 or 2, no previous upper abdominal operation, no, or well controlled hypertension or diabetes, gall bladder wall thickness with less than 6 mm by preoperative ultrasonography and all the patients were operated by the authors. The patients were divided into two groups according to the instrument used for dissection of gall bladder from its bed, the first group with electrocautery and second group with harmonic scalpel. The time needed for complete dissection and hemostasis started from spreading of Calot’s triangle till removal of gall bladder totally from its bed, was recorded. Any intra operative complications: bleeding, gallbladder perforation, slipped stones, or conversion were recorded.Results: The study included 320 patients, 172 patients belonged to the first group (electrocautery) and 148 patients belonged to second group (harmonic). For the first group, the median time was 17 minutes, the mean time was 17.7 minutes and the mode was 13 minutes, while that for second group, the median time was 14 minutes, with a mean time of 16 minutes and a mode of 14 minutes. Intra-operative bleeding was recorded in 34 (20%) for the first group and 17 (11%) for the second one. Gallbladder perforation was recorded in 26 (15%) patients and slipped stone in 12 (7%) patients in the electrocautery group and 13(9%) and 5 (3%) respectively in the harmonic group. No common bile duct injury was recorded in either group. Conversion was needed in 4 patients (1.3%), 3 (2%) patients belonged to the first group and one (06%) to the second group. Conclusion: Harmonic scalpel is very safe and effective instrument for dissection of gall bladder and hemostasis in laparoscopic cholecystectomy and can replace electrocautery for this purpose if available at operative theater. Keywords: Laparoscopic cholecystectomy, harmonic scalpel, electrocautery.

الخلاصةالهدف: لتحديد مدى الفاعلية والأمان وترقية النزوفات لجهاز السكين الصوتي في عمليات رفع المرارة بالمنظار بالمقارنة مع جهاز الكيّ الكهربائي.التصميم والمشاركون: دراسة رجعية مقارنة، ضمّت 320 مريضا مصابا بإلتهاب المرارة الحصوي المزمن.زمان ومكان الدراسة: مستشفى الجمهوري التعليمي للفترة من 1-1-2009 لغاية 1-1-2012.القياسات الإجرائية: ضمّت الدراسة 320 مريضا أجريت لهم عملية رفع المرارة بالمنظار الجراحي من قبل الباحثين وقد تم اختيار المرضى وفق المعايير التالية: إن يتراوح عمر المريض من 25 إلى 50 سنة، ومصابا بالإلتهاب المزمن للمرارة، وبدون علامات سريرية قبل العملية مباشرة، وذو وزن طبيعي، وأن لا يتجاوز مؤشر التخدير للمريض عن نقطتين، ولم تجر له عملية فتح بطن سابقا. وأن لا يكون مصابا بمرض إرتفاع ضغط الدم أو التبول السكري، أو مسيطر على هذه الإمراض إن وجدت. وأن لا يتجاوز ثخن جدار المرارة 6ملم بالفحص بالأمواج فوق الصوتية قبل العملية. بالإعتماد على ملفات العمليات للمرضى تم تقسيمهم إلى مجموعتين. المجموعة الأولى ضمّت المرضى اللذين تم إستعمال جهاز الكي الكهربائي في التداخل الجراحي لرفع المرارة من الكبد. بينما ضمّت المجموعة الثانية المرضى اللذين تم إستخدام السكين الصوتي لذلك. تم إحتساب الوقت بالدقائق لإكمال عملية رقي النزوفات والسيطرة على شريان المرارة وقناتها ورفع المرارة كاملا من الكبد. كما تم تسجيل حالات النزوفات وطرق السيطرة عليها كذلك. تم تسجيل حالات إنثقاب المرارة وإنسكاب الحصيات إلى التجويف البطني. وتم تسجيل حالات التحويل إلى عملية فتح البطن والأسباب لذلك. وتم مقارنة النتائج. النتائج: ضمّت المجموعة الأولى 172 مريضا وكان معدل الوسط الزمني لعملية تشريح المرارة والسيطرة على القناة والشريان المراري 17,7 دقيقة. تم تسجيل نزوفات بسيطة في 19 مريضا ونزوفات كبيرة في 14 و واحدة خطيرة. حدث إنثقاب في جدار المرارة عند 26 مريضا مع إنسكاب الحصيات إلى التجويف البطني في 12 مريضا. إحتاج الجراح إلى تحويل العملية إلى فتح بطن في 3 حالات. بينما ضمّت المجموعة الثانية 148 مريضا وكان معدل الوسط الزمني لعملية تشريح المرارة والسيطرة على القناة والشريان المراري 16 دقيقة. تم تسجيل نزوفات بسيطة في 15مريضا و 4 نزوفات كبيرة ولم يسجل حالة نزف خطيرة. حدث إنثقاب في جدار المرارة عند 13 مريضا مع إنسكاب الحصيات إلى التجويف البطني في 5 مرضى. إحتاج الجراح إلى تحويل العملية إلى فتح بطن في حالة واحدة فقط.الإستنتاج: عملية رفع المرارة بالمنظار بإستخدام السكين الصوتي فعالة وأمينة بالمقارنة مع إستخدام جهاز الكي الكهربائي ونحن ننصح بإستخدامها في حالة توفرها في صالة العمليات. الكلمات الدليلية: رفع المرارة بالمنظار، جهاز الكي الكهربائي، جهاز السكين الصوتي.


Article
The routine insertion of drains after total thyroidectomy by harmonic scalpel, is it always necessary?
الإدراج الروتيني للمنزح بعد استئصال الغدة الدرقية الكلي بواسطة مشرط متناسق، هل هو ضروري دائمًا؟

Author: Ali A. Al-Dabbagh
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2016 Volume: 20 Issue: 3 Pages: 1419-1423
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Routine use of drains after thyroidectomy is not evidence based; nevertheless most surgeons use drains to alert them to the presence of postoperative bleeding and for the prevention of hematoma and seroma. This comparative study was conducted to evaluate the necessity of routine drainage after total thyroidectomy.Methods: A total of 150 patients who underwent total thyroidectomy due to different indications at different hospitals in Erbil city, Iraq from June 2011 to December 2015, were included. A retrospective comparison was made between those drained (group 1) and those without drain (group 2). Operating time, postoperative complications and hospital stay were assessed.Results: Operation time was significantly less in group 2 compared to group 1; 64.9 ± 7.64 minutes versus 73.8 ± 9.81 minutes, respectively. There was no statistically significant difference in the incidence of postoperative complications. Only two patients, both from group 1, developed a postoperative hematoma. Wound infection occurred only in 2 patients in group 1. Hospital stay was significantly shorter in group 2 compared to group 1; 21.1 ± 3.98 hours versus 41.7 ± 8.64 hours, respectively.Conclusion: The routine use of drain is not necessary after total thyroidectomy; it increases the hospital stay and may increase the rate of postoperative sepsis.


Article
No Tie Technique Using Harmonic Scalpel for Thyroidectomy Versus Conventional Technique (A Prospective Study)

Author: Ali Azeez Ali
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2016 Volume: 9 Issue: 1 Pages: 2316-2323
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: The pioneers of thyroid surgery, Theodor Kocher and Theodor Billroth, developed an acceptable technique of standardized thyroid surgery in the nineteenth century. It includes three basic principles: identification and ligation of the feeding vessels, identification and preservation of the laryngeal nerves and identification and preservation of the parathyroid glands. The basic surgical instruments have not significantly changed, the main innovations are new methods of coagulation and vascular section.Aim: to compare the outcomes of total thyroidectomy and lobectomy, utilizing the conventional hemostatic technique (CH) and harmonic scalpel technique (HS).Patients and Methods: This study was carried at Al-Hussein medical city. In one group the tie and ligature technique was applied and the new harmonic scalpel technique was applied to the other group.The study variables are: operative time, post-operative drainage volume, recurrent laryngeal nerve (RLN) status and total serum calcium level in total thyroidectomy group.Student’s t test was used to compare quantitative variables, chi square test was to compare qualitative variables.Results: Seventy patients were included in this study, 40 patients had total thyroidectomy, and 30 patients underwent lobectomy.The mean operative time, in the total thyroidectomy group, was 83.4±13.2 minutes versus 60.3±5.3 minutes in the CH and HS respectively. And it was statistically significant. In the lobectomy group, the mean operative Time was 47.8±7.3 minute versus 38.8±6.8 minute in the CH and HS respectively. It was statistically significant.Post-operative drainage, in the total thyroidectomy group, was 128.6 ± 11.1 ml versus 98.1± 10.3 ml in the CH and HS group respectively. In the lobectomy group, it was 116.4±21.1 ml versus 62.8±8.6 ml in the CH and HS group respectively. And both are highly significant.Regarding RLN palsy, in the total thyroidectomy group, 2 patients out of 20 with CH versus 3 out of 20 with HS, sustained RLN palsy but statistically was non-significant. In the lobectomy group, 2 patients out of 14 with CH versus zero out of 16 patients with HS sustained RLN palsy also was non-significant.Regarding hypocalcaemia, in the total thyroidectomy group, 4 patients out of 20 with CH versus 3 patients out of 20 in the HS group developed post-operative hypocalcaemia and was statistically non-significant. Conclusion: Harmonic scalpel is a relatively safe, effective hemostatic tool in thyroid surgery. Complications are no more than that of conventional hemostatic technique.


Article
Gingival Enlargement Management using Diode Laser 940 nm and Conventional Scalpel Technique (A Comparative Study)
معالجة تضخم اللثة باستخدام الدايود ليزر 940نانومتر وتقنية المشرط التقليدية (دراسة مقارنة)

Authors: Farah E. Musaa فرح عماد الدين --- Lutfi G. Awazli لطفي غلام عوازلي --- Faaiz Alhamdani فائز الحمداني
Journal: Iraqi Journal of Laser المجلة العراقية لليزر ISSN: 18121195 Year: 2017 Volume: 16 Issue: B Pages: 1-9
Publisher: Baghdad University جامعة بغداد

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Abstract

Abstract: Background: Diode lasers are becoming popular in periodontal surgery due to their highly absorption by pigments such as melanin and hemoglobin their weak absorption by water and hydroxyapatite makes them safe to be used around dental hard tissues. Objective: The aim of the present study was to evaluate the efficiency of diode laser in performing gingivectomy in comparison to conventional scalpel technique in patients with chronic inflammatory enlargement. Materials and methods: Thirty patients were selected for this study. All of them required surgical treatment of gingival enlargements and were randomly divided into two groups: Control group (treated by scalpel and include sixteen patients) and study group (treated with diode laser 940nm and include fourteen patients). Data collected during and after surgery were compared and statically analyzed. Results: Fifteen male and fifteen female were included in this study with age mean of 26.2. Significant differences were observed in the Gingival Index and bleeding scores in laser group compared to the scalpel group, while no significant differences were found in swelling score and plaque index, The level of significance was set at P≤ 0.05.Conclusion: Diode laser 940nm are beneficial in achieving hemostasis with the improvement of gingival health compared to the scalpel technique.

الخلاصة : الهدف:الهدف من هذه الدراسة هو لتقييم كفاءة الدايود الليزر 940نانومتر في أداء عملية قطع اللثة بالمقارنة مع تقنية مشرط التقليدية للمرضى الذين يعانون من تضخم التهابي مزمن في اللثة المقدمة: ليزر الدايود أصبح ذا شعبية في جراحة اللثة نظرا لامتصاص الكبير من قبل ألاصباغ مثل الميلانين والهيموجلوبين مع قابلية امتصاص ضعيفة عن طريق الماء وهيدروكسي اباتيت مماجعلها آمنة للاستخدام في جميع أنحاء الأنسجة الصلبةللأسنان. المواد والطرق: تم اختيار ثلاثين مريضا لهذه الدراسة، عن العلاج الجراحي المطلوب من التوسعات اللثة، قسمت عشوائيا إلى مجموعتين. وتمت مقارنة مجموعة المراقبة (يعامل من قبل مشرط) ومجموعة الدراسة (تعامل مع دايود ليزر 940 نانومتر)، البيانات التي تم جمعها أثناء وبعد الجراحة وتحليلها بشكل ثابت. النتائج: أدرجت خمسة عشر ذكرا وخمسة عشر الأنثى في هذه الدراسة بمتوسط عمر26.2 وقد لوحظت فروق ذات دلالة إحصائية في مؤشر اللثة والنزيف في مجموعة ليزر مقارنة مع مجموعة مشرط في حين أن هناك لا توجد فروق ذات دلالة إحصائية في درجة التورم ومؤشر البلاك ، تم تعيين مستوى أهمية في P≤ 0.05. الاستنتاج: ليزر الدايود 940نانومتر مفيد في تحسين صحة اللثة مقارنة مع تقنية المشرط.


Article
Harmonic Knife New Haemostatic Procedure In Thyroid Surgery

Author: Thamer T. Al-Ali CABS*, Ayad. J .Matar CABS**, Ahmad Almarzuik *** ; Thamer. S. Alkurawi DNM****
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2017 Volume: 13 Issue: 1 Pages: 142-145
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Thyroid operation needs very meticulous haemostasis to have minimal morbidity and mortality. Objectives: Assessment of harmonic knife in open thyroid surgery as anew haemostatic procedure .Type of the study: Cross-sectional study.Methods: This study had been conducted at Alkindy teaching hospital in Baghdad city from the 1st of May 2013 to the 1st of January 2017 on 229 goiterous patients who needs thyroidectomy(36 males,193 females),divided in 2 groups according to the haemostatic procedure used during their operations, Group A (15 males,85females)using the usual conventional surgery(pick, tie &cut), Group B (21males,108 females) using harmonic knife as haemostatic procedure and compare the results according to time of surgery, amount of discharge in the drain during the first 24 hours post operatively ,the incidence of recurrent nerve palsy and the remote post operative hypocalcaemia (3months post operation) .Results: It shows that thyroid surgery (thyroidectomy) by using harmonic knife as haemostatic procedure is shorter in duration [mean67.22 minutes] with less blood loss in the drain [mean 64.96cc] and less incidence of hypocalcaemia in remote post operative period [3.8%] in comparison to the results of the usual conventional thyroidectomy procedures (mean duration 82.02 minutes, mean blood loss in the drain 111.13cc & incidence of hypocalcaemia is 7%}. Conclusions: Harmonic knife is very safe & beneficial haemostatic device in thyroid surgery.


Article
A COMPARATIVE STUDY BETWEEN HARMONIC SCALPEL HEMOSTASIS AND CONVENTIONAL HEMOSTASIS IN TOTAL AND SUBTOTAL THYROIDECTOMY

Authors: Mohammed Salim Mohammed --- Jasim D Saud --- Mansour Amin Mohammed --- Mazin H Al-Hawaz
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2017 Volume: 23 Issue: 2 Pages: 15-20
Publisher: Basrah University جامعة البصرة

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Abstract

A COMPARATIVE STUDY BETWEEN HARMONIC SCALPEL HEMOSTASIS AND CONVENTIONAL HEMOSTASIS IN TOTAL AND SUBTOTAL THYROIDECTOMYMohammed Salim Mohammed*, Jasim D Saud#, Mansour Amin Mohammed$ & Mazin H Al-Hawaz@ *MB,ChB, Board Candidate. #MB,ChB, FICMS, CABS, Consultant Surgeon, Basrah General Hospital. $MB,ChB, DS, CABS, MRCS, Lecturer, Dept. of Surgery, College of Medicine. @ MB,ChB, CABS, DGS, FRCS, Prof. of General Surgery, Basrah Medical College., Basrah, IRAQ.Abstract Thyroid gland is highly vascularized organ, so good hemostasis during total or sub-total thyroidectomy is crucial to decrease the complications and to improve the outcome. This study aimed to evaluate the advantages and disadvantages of using harmonic scalpel device in comparison with conventional hemostasis for total and subtotal thyroidectomy in terms of operative time, nerves injury, post-operative blood loss, hematoma development, hypocalcemia and length of hospital stay. This study included 80 patients who underwent total or subtotal thyroidectomy. They were divided into two groups according to the type of hemostasis: conventional hemostasis group and harmonic hemostasis group. Different diseases were included (multinodular goiter, toxic goiter and malignant diseases). The results showed that time of operation was significantly shorter in the harmonic hemostasis group (79.52±14.98 min) than conventional hemostasis group (100.92 ±10.64 min) with p value 0.0001, also post-operative blood loss was lower in harmonic hemostasis group (52.5±26.23 ml) than conventional hemostasis group (75.13±17.8 ml) with p value 0.0001. Other outcome such as recurrent laryngeal nerve injury, post-operative hematoma, post-operative hypocalcemia and length of hospital stay did not show significant difference between the groups. In conclusion, using harmonic scalpel device in total or subtotal thyroidectomy reduced the operative time and post-operative blood loss, without any change in the incidence of nerve injury, hematoma, hypocalcemia and the length of hospital stay.


Article
Sutureless Focus Harmonic Thyroidectomy versus Conventional Clamping and Knot‑Tying Technique

Author: Ibrahim Falih Noori, Mansour Amin Mohammad
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2018 Volume: 15 Issue: 4 Pages: 300-305
Publisher: Babylon University جامعة بابل

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Abstract

Background: Thyroidectomy is the most frequent procedure in endocrine surgery. Since thyroid is the highly vascular organ, therefore, promptand meticulous hemostasis is extremely important. Although conventional thyroidectomy is used frequently with acceptable outcomes, it istime‑consuming and resulted in significant intraoperative blood loss with possible risk of injury to parathyroid glands and laryngeal nerves. Theadvent of ultrasonically activated focus harmonic device in thyroid surgery was encouraging for improving safety, effectiveness, and reductionof operative time. Aim of this Study: The purpose of this study was to analyze the effectiveness and surgical outcomes of using ultrasonicharmonic scalpel for thyroid surgery compared to conventional techniques (clamping and suture ligation (knots tying) and electrocautery.Patients and Methods: This is a prospective, randomized study in which 64 patients with various types of goiters presented for thyroidectomy.The patients were divided into two comparable groups. Group A (32 patients) included patients who had focus harmonic thyroidectomy andGroup B (32 patients) included patients who received conventional thyroidectomy. Results: Focus harmonic thyroidectomy showed significantreduction in operative time, intraoperative blood loss, volume of postoperative fluid drainage, and postoperative pain scores compared withconventional thyroidectomy. There were no significant differences in the incidence of postoperative hypocalcemia and laryngeal nerve injurybetween both the groups. The total cost of focus harmonic thyroidectomy and hospital stay were also less compared with conventional techniques.Conclusions: Focus harmonic thyroidectomy was a safe, effective, faster, and beneficial alternative to conventional technique since it reducesthe time of surgery, blood loss, postoperative drainage, and pain with comparable postoperative complications


Article
Clinical Comparison between Diode Laser and Scalpel Incisions in Oral Soft Tissue Biopsy

Authors: Wael S Shalawe --- Zaid A Ibrahim --- Ali D Sulaiman
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2012 Volume: 12 Issue: 20 Pages: 337-343
Publisher: Mosul University جامعة الموصل

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Abstract

Aims of the study: To compare the new diode laser (1064nm) incision with conventional blade inci-sion wounds after oral soft tissue biopsy in terms of haemostasis, local anesthetic required, duration of incision and post operative pain. Materials and Methods: This study was conducted in the Oral and Maxillofacial Surgery Department at College of Dentistry/University of Mosul and Oral and Maxil-lofacial Surgery Department in Al-Salam Teaching Hospital between February 2010 and May 2010. Thirty patients were enrolled and divided into two groups, each consisted of fifteen patients. The first group included fifteen patients requiring biopsy (based on their indications for biopsy) in the oral cavi-ty, where the incision was done using surgical blade no.15. The second one included fifteen patients who needed biopsy in the oral cavity (based on their indications for biopsy), here the incision was made by using diode laser (FOXTM, A.R.C. laser, Germany) wavelength 1064nm with output power (3.5Watt) CW in contact with the tip of bare fiber (200micron). All biopsies in the two groups were excisional and done under local anesthesia using infiltration technique. Results: In comparison be-tween the two groups: the amount of local anesthetic required in the second group (diode laser wound group 0.73 ml) was less than that required by the first group (blade incision wound group 1.6 ml) and showed statistically high significance at p value < 0.05. The mean of the difference in the weight of the gauze before and after the operation in the second group(0.16 gm) was less than the difference in the weight of the gauze in the first group(0.96 gm) which showed statistically high significance at p value <0.05. The mean of the duration for incision was statistically not significant between the two groups and the mean of pain score at the first post-operative day was statistically significant in the second group in comparison to the first group but there was no statistical difference in the pain score level at the third postoperative day between the two groups. Conclusion: The use of Diode (1064nm) laser to perform oral biopsy has several advantages over the blade incisions wound including less amount of local anesthesia required, enhanced haemostasis (suturing after surgery was not necessary) , minimal postoperative pain.


Article
IMPACT OF THE HARMONIC SCALPEL HEMOSTASIS IN TOTAL THYROIDECTOMY IN COMPARISON WITH CONVENTIONAL HEMOSTATIC TECHNIQUE

Authors: Sadq Ghaleb Kadem --- Raheem Sharhan Balasim
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2016 Volume: 22 Issue: 2 Pages: 63-68
Publisher: Basrah University جامعة البصرة

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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.

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