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Invited Commentary
September 18, 2019

Implementation of Vessel-Sealing Devices in Thyroid Surgery

Author Affiliations
  • 1Department of Surgery, University of Alabama at Birmingham, Birmingham
  • 2Department of Surgery, Medical College of Wisconsin, Milwaukee
JAMA Surg. Published online September 18, 2019. doi:10.1001/jamasurg.2019.3159

…can the thyroid…be removed…? If a surgeon should be so adventurous or foolhardy as to undertake the enterprise…Every step he takes will be environed with a torrent of blood, and lucky will it be for him if his victim live long enough to enable him to finish his horrid butchery.

Samuel D. Gross, A System of Surgery, 18661

Since the 1800s, thyroidectomy has evolved from an operation with a 40% mortality rate because of uncontrolled bleeding to one with near-zero mortality rates and morbidity rates of less than 5% in the hands of experience thyroid surgeons.2,3 Traditionally, hemostasis in thyroid surgery was achieved with meticulous dissection, electrocautery, and the tying or clipping of vessels (conventional hemostasis [CH]).3,4 The relatively recent development of vessel-sealing devices (VSDs) has led to their increased use during thyroidectomy and studies4-6 comparing outcomes of using CH to VSD, with mixed results.

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