Background: The purpose of this study was to investigate and define safety parameters for using the Ligasure exact dissector (LED) for dissection close to the recurrent laryngeal nerve (RLN) during thyroidectomy. Methods: Real-time electrophysiologic electromyographic (EMG) tracings were recorded in 16 RLNs (8 piglets) during various applications of LED under continuous intraoperative monitoring in this prospective porcine model study. In the activation study, LED was activated at varying distances from the RLN. In the cooling study, LED was activated with different cooling times or after touching the sternodeidomastoid muscle before application to the RLN. Results: In the activation study, no adverse EMG events occurred at distances longer than I rum. In the cooling study, no adverse EMG events occurred after a 2-second cooling time. Additionally, no adverse EMG events occurred when a sternodeidomastoid muscle touch maneuver was used for cooling. Conclusions: The LED can be safely used at distance of 1 mm or longer, and it should be cooled for at least 2 seconds or by muscle touch maneuver. Thyroid surgeons can avoid RLN injury if standard procedures for LED use are observed.
Safety of Ligasure exact dissector in thyroidectomy with continuous neuromonitoring: a porcine model / T. Huang, Y. Lin, H. Tseng, G. Dionigi, H. Kim, I. Lu, P. Chang, F. Chiang, C. Wu. - In: GLAND SURGERY. - ISSN 2227-684X. - 9:3(2020 Jun), pp. 702-710. [10.21037/gs.2020.03.17]
|Titolo:||Safety of Ligasure exact dissector in thyroidectomy with continuous neuromonitoring: a porcine model|
|Parole Chiave:||Recurrent laryngeal nerve (RLN); Ligasure exact dissector (LED); continuous neuromonitoring; thyroid surgery; nerve thermal injury;|
|Settore Scientifico Disciplinare:||Settore MED/18 - Chirurgia Generale|
|Data di pubblicazione:||giu-2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.21037/gs.2020.03.17|
|Appare nelle tipologie:||01 - Articolo su periodico|