The Safety and Efficacy of the Harmonic Scalpel in Neck Dissection

Recently, the HS has been used in head and neck surgery as an alternative to conventional hand-tied ligation for hemostasis, which is a time-consuming procedure. Limited data have been published on the evidence of its safety in ND, especially in radical ND. Researchers investigated the safety and efficacy of the Harmonic scalpel (HS) in neck dissection (ND), while using conventional hand-tied ligation to a minimum, in terms of operating time, blood loss, drainage and complications.

Harmonic Focus® Curved Shears (Ethicon Endo-Surgery, Cincinnati, OH) was used for vascular control of the surgery regardless of vessel diameter, except when hand-tied or suture ligation was needed for IJV ligation or in case bleeding was not controlled with electrocoagulation

electrocautery was used to control the small vessels and conventional hand-tied ligation was used for large sized arterial, venous, or lymphatic vessels.

The Harmonic Focus® Curved Shears (Ethicon Endo-Surgery, Cincinnati, OH) was used for vascular control of the surgery regardless of vessel diameter, except when hand-tied or suture ligation was needed for IJV ligation or in case bleeding was not controlled with electrocoagulation

electrocautery was used to control the small vessels and conventional hand-tied ligation was used for large sized arterial, venous, or lymphatic vessels

major vessel laceration, major nerve injury, and penetration into adjacent vital structures such as trachea or esophagus

complicated events will be monitored during the operation which takes 60 min to 160 min according to the extent of surgery

The time from the first procedure after subplatysmal flap elevation to removal of neck dissection specimen will be measured

when the neck dissection specimen is removed from the patient at an average time of 60 min to 160 min according to the extent of surgery

The amount will be estimated at the end of the surgery at an average time of 60 min to 160 min according to the extent of surgery

estimated until the drain tube is removed at the average of 4 to 7 days according to the extent of surgery

estimated at 6AM daily, until the drain is removed at an average of 4 to 7 days according to the extent of surgery

documented when the patient leaves the hospital at an average time of 10 to 28 days according to the extent of surgery

Inclusion Criteria: preoperative diagnosis of head and neck squamous cell carcinoma surgery as initial treatment Exclusion Criteria: cases in which the ND specimen could not be separated from the primary tumor past history of neck surgery

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