Complications associated with energy-based devices during thyroidectomy from 2010-2020

Authors

Esther Lee, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine & Health Sciences Washington DC USA.
Jane Y. Tong, Department of Otolaryngology-Head and Neck Surgery Drexel University College of Medicine Philadelphia PA USA.
Luke J. Pasick, Department of Otolaryngology-Head and Neck Surgery University of Miami Miller School of Medicine Miami FL USA.
Daniel A. Benito, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine & Health Sciences Washington DC USA.
Arjun Joshi, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine & Health Sciences Washington DC USA.
Punam G. Thakkar, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine & Health Sciences Washington DC USA.
Joseph F. Goodman, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine & Health Sciences Washington DC USA.

Document Type

Journal Article

Publication Date

3-1-2023

Journal

World journal of otorhinolaryngology - head and neck surgery

Volume

9

Issue

1

DOI

10.1016/j.wjorl.2021.04.008

Keywords

Adverse events; Harmonic; LigaSure; Manufacture and User Facility Device Experience; Patient safety; Quality; Thunderbeat; Thyroidectomy

Abstract

OBJECTIVE: Harmonic Focus (Ethicon, Johnson and Johnson, Cincinnati, OH, USA), LigaSure Small Jaw (Medtronic, Covidien Products, Minneapolis, MN, USA), and Thunderbeat Open Fine Jaw (Olympus, Japan) are electrosurgical instruments used widely in head and neck surgery. The study aims to compare device malfunctions, adverse events to patients, operative injuries, and interventions related to Harmonic, LigaSure, and Thunderbeat use during thyroidectomy. METHODS: The US Food and Drug Administration's Manufacture and User Facility Device Experience (MAUDE) database was queried for adverse events associated with Harmonic, LigaSure, and Thunderbeat from January 2005 to August 2020. Data were extracted from reports pertaining to thyroidectomy. RESULTS: Of the 620 adverse events extracted, 394 (63.5%) involved Harmonic, 134 (21.6%) LigaSure, and 92 (14.8%) Thunderbeat. The reported device malfunctions most frequently associated with Harmonic was damage to the blade (110 (27.9%)), LigaSure was inappropriate function (47 (43.1%)), Thunderbeat was damage to the tissue or Teflon pad (27 (30.7%)), respectively. Burn injury and incomplete hemostasis were the most commonly reported adverse events. The operative injury reported most frequently when using Harmonic and LigaSure was burn injury. No operator injuries were reported with Thunderbeat use. CONCLUSION: The most frequently reported device malfunctions were damage to the blade, inappropriate function, and damage to the tissue or Teflon pad. The most frequently reported adverse events to patients was a burn injury and incomplete hemostasis. Interventions aimed at improving physician education may help reduce adverse events attributed to improper use.

APA Citation

Lee, Esther; Tong, Jane Y.; Pasick, Luke J.; Benito, Daniel A.; Joshi, Arjun; Thakkar, Punam G.; and Goodman, Joseph F., "Complications associated with energy-based devices during thyroidectomy from 2010-2020" (2023). GW Authored Works. Paper 2625.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2625

Department

Surgery