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LigaSure vs Clamp-and-Tie Technique to Achieve Hemostasis in Total Thyroidectomy for Benign Multinodular Goiter—Invited Critique
Richard A. Prinz, MD;
Naris Nilubol, MD;
Subhash Patel, MD
Arch Surg. 2007;142(2):157.
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In 1909, Theodor Kocher received the Nobel Prize for his contributions to thyroid surgery. By emphasizing a thorough knowledge of anatomy and meticulous surgical technique, he was able to reduce the mortality of thyroid surgery from more than 13% to 1%.1 His bloodless approach was popularized in America by Halsted.2 Thompson et al3 refined these techniques by ligating individual vessels as they enter the gland and routinely visualizing the parathyroid glands and the recurrent laryngeal nerves. This has decreased the rate of permanent postoperative hypoparathyroidism from 15% to 0.45%, and of recurrent laryngeal nerve injury from 25% to 2.7%.4
Surgeon experience and meticulous control of blood vessels are the keys to safe thyroid surgery. The mainstay for a bloodless thyroidectomy, which is essential if the surgeon is to see all of the anatomy, has been the CT method of hemostasis. . . . [Full Text of this Article] AUTHOR INFORMATION
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