Thyroidectomy Complications after Ligasure Small Jaw Use, Case Series, Prospective Study.

Introduction: The Ligasure small jaw (LISJ) is believed to provide several benefits for thyroid surgery. The use of LISJ by non-expert surgeons or those who erroneously assume its extensive usage can reduce postoperative bleeding may, in reality, pose a considerable risk of additional severe consequences.

Material and methodology: Between March and December of 2022, I analyzed complications following total thyroidectomy (TTH) case series for 10 patients who underwent surgery for papillary thyroid cancer by one qualified surgeon using LISJ. Cohorts were evaluated prospectively including hypocalcemia (HC) and recurrent laryngeal nerve (RLND) palsy.

Results: All 10 patients experienced postoperative hypocalcemia (HC), necessitating a postoperative calcium supplement with vitamin D. One patient suffered stridor after extubation.

Conclusion: The Ligasure Small Jaw serves as an effective hemostatic device, but it requires more attention in complete thyroidectomy. During a complete thyroidectomy, the Ligasure Small Jaw's lateral heating action may affect delicate structures more often than reported. Such damage could lead to hypocalcemia, which could be temporary or permanent, and recurrent laryngeal nerve palsy. More research would provide greater insights into the anticipated complication rates, particularly when conducted by less experienced specialized surgeons.