COMPARISON OF OUTCOME OF THYROIDECTOMY BY HARMONIC SCALPEL WITH IDENTIFICATION OF RECURRENT LARYNGEAL NERVE VS WITHOUT IDENTIFICATION OF RECURRENT LARYNGEAL NERVE

Abstract

Background: Thyroidectomy is one of the most common surgical procedures performed and preservation of the recurrent laryngeal nerve (RLN) is essential to avoid morbidity related to voice. There is still a debate about the outcomes of RLN identification with the harmonic scalpel.

Objective: To compare the outcome of thyroidectomy surgery by harmonic scalpel with identification of recurrent laryngeal nerve Vs without identification of recurrent laryngeal nerve.

Methods: This was a randomized control trial that was carried out at Department General surgery at Sheikh Zayed Hospital, Rahim Yar Khan from May 2025 to September 2025. Total One hundred and thirty patients were divided into two groups, Group A (RLN identification) and Group B (no RLN identification) of equal size. The outcomes measured included operative time, blood loss, pain level at the end of the procedure, drainage time, hypocalcemia, hematoma and RLN injury.

Result:  Group A had lower rate of RLN injury, fewer postoperative complications and a better safety profile than Group B, although the operative time was somewhat longer in Group A, but the overall morbidity was significantly decreased. Another postoperative evaluation parameters, such as pain score, blood loss and hospital stay were also found to be lower in RLN identification group.

Conclusion: RLN identification during harmonic scalpel thyroidectomy is a very useful procedure that increases the safety of the surgical procedure and decreases complications just as much as it does not increase the surgical time, which makes it suitable for thyroid surgery.