Hospital-Customised HTA of Vessel Sealing Systems in Thyroidectomy

Thyroid cancer is the most frequent among cancers of the endocrine system. In thyroidectomy, obtaining and maintaining secure vessels ligation is fundamental. This study aims to assess the traditional haemostatic technique (i.e., classic suture ligation) and vessel sealing systems (i.e., disposable bipolar vessel sealer, reusable bipolar vessel sealer, and disposable ultrasonic coagulating shear) in thyroidectomy, in order to identify the best technology to be used at the “G. Pascale” hospital (Naples, Italy). After definition of the research question, we conducted a systematic review of the literature to assess the clinical effectiveness. Then, we assessed the economic dimension performing the Break-Even Point analysis. Results showed that vessel sealing systems can reduce surgery duration, intra-operative bleeding and incidence of hypocalcaemia compared to the traditional haemostatic technique. However, the traditional haemostatic technique is the most cost-effective and the Break-Even Point can be reached after 29.08 surgeries using disposable bipolar vessel sealer, 25.65 using reusable bipolar vessel sealer and 182.59 surgeries using ultrasonic coagulating shear. According to our analysis, the disposable bipolar vessel sealer appears to be an effective and economically sustainable option for thyroidectomy at the “G. Pascale” hospital.