A Comparison Between Combined Ultrasonic and Bipolar Shears to Other Energy-Based Devices in Otolaryngology: A Systematic Review and Meta-Analysis

Objective: The Thunderbeat (TB) is a new surgical device that combines ultrasonic and bipolar energy. The objective of this study is to examine how the combined ultrasonic and bipolar shears affect surgical outcomes when compared to other methods.

Data sources and review methods: Using the PRISMA guidelines, the researchers used broad search terms in PubMed, Embase, and Web of Science, which produced a total of 2823 initial results, with years ranging from 1955 to June 2024. After applying inclusion and exclusion criteria, 8 final studies were included in this systematic review and meta-analysis.

Results: This meta-analysis analyzes energy-based devices used on patients into 2 major groups: (1) thyroidectomy group and (2) neck dissection group. The researchers found that the use of the TB in thyroidectomies reduces operative time when compared to the Harmonic scalpel (HS) and Ligasure (LS). The pooled mean difference in thyroidectomy operation time for the TB vs HS was -5.77 min (95% CI: -11.07 to -.48, P-value: .03) and for the TB vs LS was -4.41 min (95% CI: -8.86 to .04, P-value: .05). We also found reduced operative time with the use of the TB vs standard electrocautery for neck dissection, where the mean difference was -39.76 min (95% CI: -63.00 to -16.51, P-value: .00). No significant differences were seen in blood loss or postoperative complications when comparing TB to other methods.

Conclusion: This meta-analysis demonstrated that TB can be equivalent to other energy-based devices and shows potential advantages over traditional electrocautery.