The recurrent laryngeal nerve (RLN) injuries are frequent complications related to thyroid surgery determining patient complaints and malpractice litigations. In the present work, the authors provide a brief review on the peculiarities of RLN injuries associated with thyroidectomy to highlight the various aspects of medicolegal assessment of causal link between surgery and nerve damage. The characteristics of thyroid disease, the anatomical peculiarities of surgery site and the nerve identification and preservation are factors that mostly influence the liability admission or rejection. In this context, the clinical records are fundamental, representing the most important probative tool. The possibility of having a set of information collected by clinical records, which allows for analysis and comparison to be made regarding the adherence to standards for thyroid surgery, is essential to set any medico-legal deliberation. However, the medicolegal evaluation can be very difficult. The practitioners involved in the medicolegal analysis of patient complaints related to this thyroidectomy complication need an in-depth knowledge of surgical technique, damage prevention activities and related clinical picture. To this must be added an adequate competence in the evaluation of the causal link (relation between the event and the injury and between that injury and the temporary/permanent impairment) based on the rigorous application of the medicolegal method.

Narrative review of proving the causal link of recurrent laryngeal nerve injury and thyroidectomy : a medico legal appraisal / P. Gualniera, S. Scurria, C. Mondello, A. Asmundo, D. Sapienza, G. Dionigi. - In: GLAND SURGERY. - ISSN 2227-684X. - 9:5(2020), pp. 1564-1572. [10.21037/gs-20-203]

Narrative review of proving the causal link of recurrent laryngeal nerve injury and thyroidectomy : a medico legal appraisal

G. Dionigi
Ultimo
2020

Abstract

The recurrent laryngeal nerve (RLN) injuries are frequent complications related to thyroid surgery determining patient complaints and malpractice litigations. In the present work, the authors provide a brief review on the peculiarities of RLN injuries associated with thyroidectomy to highlight the various aspects of medicolegal assessment of causal link between surgery and nerve damage. The characteristics of thyroid disease, the anatomical peculiarities of surgery site and the nerve identification and preservation are factors that mostly influence the liability admission or rejection. In this context, the clinical records are fundamental, representing the most important probative tool. The possibility of having a set of information collected by clinical records, which allows for analysis and comparison to be made regarding the adherence to standards for thyroid surgery, is essential to set any medico-legal deliberation. However, the medicolegal evaluation can be very difficult. The practitioners involved in the medicolegal analysis of patient complaints related to this thyroidectomy complication need an in-depth knowledge of surgical technique, damage prevention activities and related clinical picture. To this must be added an adequate competence in the evaluation of the causal link (relation between the event and the injury and between that injury and the temporary/permanent impairment) based on the rigorous application of the medicolegal method.
injury; near total thyroidectomy; professional liability; Recurrent laryngeal nerve (RLN); thyroidectomy
Settore MED/18 - Chirurgia Generale
Article (author)
File in questo prodotto:
File Dimensione Formato  
gs-09-05-1564-update.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 611.88 kB
Formato Adobe PDF
611.88 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/883177
Citazioni
  • ???jsp.display-item.citation.pmc??? 7
  • Scopus 8
  • ???jsp.display-item.citation.isi??? 8
social impact