Introduction

Endocrine surgery, like all areas of surgery, relies on adequate haemostasis, which is a vital part of any surgical operation. Serious morbidity and even mortality can occur due to inadequate control of bleeding. The most well-documented complication of haemorrhage in endocrine surgery occurs with bleeding following thyroidectomy. This results in a rapid rise in pressure within a closed space, which can threaten the airway and even the life of the patient.

In a hospital setting postoperative monitoring and emergency treatment for haemorrhage is possible, but with the expansion of day surgical services, where bleeding may occur at home, adequate haemostasis becomes even more critical.1 Postoperative bleeds requiring a return to theatre occur in 0.5 to 1% of patients, with 75%

occurring within the first 4 to 6 hours and 25% within 7 to 24 hours. Haemorrhage can also occur later.2

Meticulous haemostasis is vital in minimally invasive surgical procedures, where access and surgical view is limited. Blood will obscure the operative field, and in the case of endoscopic operations will also absorb the light, making surgery more hazardous.

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