Background and purpose: In recent years

energy-based instruments have been widely used in today’s open surgeries. Harmonic Focus

®

(HF) and Ligasure Small Jaw

®

(LSJ) are both custom-made for thyroid open surgery. This study aimed to explore the efficacy and safety of HF and LSJ in open thyroidectomy. Methods: The data from patients who undertook total thyroidectomy

with central neck dissection by the same surgeon during last year in this hospital were reviewed. HF was used in 100 patients

and LSJ was used in 104 patients. The effectiveness was appraised by comparing operation time and postoperative volume of drainage on the first postoperative day. The safety was appraised by comparing the incidence of postoperative complications. Results: The results of the effectiveness: the average duration of operation was (95.8±18.0) min for HF group

and (97.8±19.1) min for LSJ group

there was no statistical significance (P=0.363). Postoperative volume of drainage on the first postoperative day was (35.2±20.3) mL for HF group

and (36.3±23.8) mL for LSJ group

there was no statistical significance (P=0.977). One patient (1.0%) had temporary vocal cord paralysis in HF and one had postoperative hematoma (1.0%) in LSJ group. Temporary hypoparathyroidism was detected in 18 patients (18.0%) of HF group

and 16 patients (15.4%) of LSJ group. The decline of parathyroid hormone during the first postoperative day was (12.3±12.8) pg/mL in HF group

and (13.9±13.4) pg/mL in LSJ group. The decline of serum calcium was (0.20±0.13) mg/dL in HF group

and (0.20±0.16) mg/dL in LSJ group. There were all no statistical significances (P＞0.05). Conclusion: Both HF and LSJ are safe and effective in open thyroidectomy without similar operative complications.