COMPARISON OF LIGASURE VERSUS CLAMP AND KNOT TECHNIQUE FOR TOTAL THYROIDECTOMY IN TERMS OF INTRAOPERATIVE BLOOD LOSS

Abstract

Objectives
To compare the effectiveness of the LigaSure vessel sealing system with the conventional clamp-and-knot ligation technique in total thyroidectomy, focusing on operative time, intraoperative blood loss, and postoperative complications.

Methodology
This randomized controlled trial was conducted in Surgical Unit II, DHQ Hospital Gujranwala during July 2025 and November 2025. A total of 60 patients aged 18–70 years with clinically diagnosed multinodular goiter and euthyroid status were enrolled through non-probability consecutive sampling. Patients were randomly allocated into two groups: Group A underwent thyroidectomy using LigaSure, and Group B underwent conventional thread ligation. All procedures were performed by a single surgical team. Quantitative variables, including operative time and blood loss, were analyzed using an independent sample t-test, while qualitative outcomes, including wound infection and seroma formation, were compared using the chi-square test. A p-value ≤ 0.05 was considered significant.

Results
Baseline demographic and clinical characteristics were comparable between the two groups (p > 0.05). The mean operative time was significantly shorter in the LigaSure group (68.4 ± 6.9 minutes) compared to the conventional group (83.1 ± 7.4 minutes; p < 0.001). Similarly, mean intraoperative blood loss was significantly lower in Group A (60.7 ± 4.5 mL) versus Group B (72.9 ± 4.1 mL; p < 0.001). Postoperative wound infection and seroma rates were lower in the LigaSure group but were not statistically significant.

Conclusion
LigaSure significantly reduced operative time and intraoperative blood loss without increasing postoperative complications, demonstrating a safe and efficient alternative to the conventional clamp-and-knot technique for total thyroidectomy.