The use of harmonic scalpel in breast cancer suregery.

Abstract

BACKGROUND: Harmonic scalpel is an alternative tool for surgical dissection. The aim of this study is to evaluate differences in clinical outcomes relating to Harmonic Scalpel when compared to Electrocautery in patients undergoing major breast surgery in a regional centre over a two period. METHODS: Retrospective chart analysis was conducted of 52 patients undergoing major breast surgery for carcinoma or DCIS by a single surgeon in a regional centre from 2008-2011. Analysis involved the extraction of qualitative data relating to patient demographics, surgery type and specimen histopathology. Quantitative data was extracted relating to duration of surgery, duration of PCA use, length of hospital admission, drainage output, and presence of infection, haematoma or seroma. RESULTS: Fifty-two patients underwent major breast surgery; Harmonic scalpel n=32 and Electro cautery n=20. The two groups were comparable. There was no significant difference identified relating the outcome measures. The median operative duration was shorter in the Harmonic scalpel group however was not of statistical significance. No significant difference was identified between groups relating to length of inpatient stay, duration of PCA use, and total volume wound drainage and total days of drainage. Incidence of seroma and infection in the groups was not significantly different. CONCLUSION: The Harmonic Scalpel is safe and effective in major breast surgery. The study did not demonstrate any clinical advantage from the use of Harmonic Scalpel in major breast surgery compared to Electrocautery, nor was there any difference in the complication rates measured.