الفهرس 
INTRODUCTION
AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
During the last decade, alternative techniques for improving safety, effectiveness and even invasiveness of thyroidectomy have been proposed, including video-assisted and endoscopic surgery, nerve monitoring and less invasive forms of anaesthesia.
Innovation regarded also the haemostatic techniques.
In addition to conventional ligatures, haemostasis can be achieved by clips, staples and several types of energy (electric monopolar and bipolar, laser, ultrasonic).
The conventional knot tying technique requires a large number of surgical ties and therefore is time-consuming. Clips work for large vessels and are subject to dislodgment, whereas staples are wasted and costly for multiple single vessels applications.
The aim of this study was to evaluate safety and feasibility of the Harmonic focus scalpel during open subtotal thyroidectomy by comparing two groups ; the first included 20 patients scheduled for open subtotal thyroidectomy using the conventional suture ligation technique and the second included 20 patients scheduled for open subtotal thyroidectomy using the Harmonic focus scalpel .
Our evaluation was based on comparing the operative time and post operative complications in both groups .
In our results we founded that the operative time has been decreased , also the postoperative drainage volume has been decreased in group two where we used the Harmonic Focus Scalpel .Post operative pain and other complications like Recurrent laryngeal nerve injury or hypocalcaemia were the same in both groups .Days of hospitalization were the same in both groups.
Finally and according to our experience in Assiut University Hospital the use of Harmonic Focus Scalpel is safe and effective during open subtotal thyroidectomy and can improve the surgical outcome .