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Purpose The aim of this prospective study was to compare operative factors,postoperative outcomes and surgical complications of open total parathyroidectomy between the Harmonic Focus (Focus group) and the classic haemostasis (classic group).Methods Fifty-six patients with secondary hyperparathyroidism underwent open total parathyroidectomy were randomized into two groups:the Focus group and the classic group.We recorded these following data:age,sex,haemostatic technique,operative time,drainage volume,length of incision,postoperative incision pain,postoperative complications,and hospital stay.Results No significant difference was found between the two groups concerning postoperative serum PTH and mean hospital stay(P>0.05).But the mean operation time and the length of incision were significantly shorter and the total drainage fluid volume was lower in Focus group (P< 0.05).The Focus group experienced significantly less postoperative incision pain at 24 and 48 hours(P< 0.05).One transient recurrent laryngeal nerve palsy was observed in the classic group and no one in the Focus group.After operation,pruritus,the bone pain and muscle weakness disappeared,and serum PTH and serum phosphate were declined markedly.Conclusions In patients undergoing total parathyroidectomy,Harmonic Focus may be a reliable and safe alternative.