Revolutionary Devices and Techniques in the Use of The Radiofrequency ablation for thyroid nodules cysts and thyroid cancer.

Revolutionary Devices and Techniques in the Use of The Radiofrequency ablation for thyroid nodules cysts and thyroid cancer.

Revolutionary Devices and Techniques in the Use of The Radiofrequency ablation for thyroid nodules cysts and thyroid cancer.

Revolutionary Devices and Techniques in the Use of The Radiofrequency ablation for thyroid nodules cysts and thyroid cancer. These devices and techniques make RFA even safer and allows endocrinologists to train in RFA and eventually do procedures in their office without conscience sedation.

Main paper describing these advances.

Thyroid Radiofrequency Ablation: Updates on Innovative Devices and Techniques

HS Park, JH Baek, et al
Korean J.Radiology 2017;18(4):615-623
My summary of the breakthrough devices and techniques.
                                      Devices
1. Bipolar electrode where there is no need for grounding pads as a second electrode removes the electricity. Advantage: For pregant females and pacemaker patients.
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images
2. 3.8 mm hot tip for small recurrent cancers and primary
micro-papillary cancer as alternative to surgery or active
surveillance.
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3. Virtual needle tracking system: Teaching device for beginners.
It allows the operator to know always where the hot tip is located
by a green V at the tip.
tracker
4. Unidirectional electrode: Useful for treatment of tumor partially
attached to a critical structure.
Figue A longitudinal view Figure B Transverse view.
Active tip is partially insulated so creates a half moon shaped ablation zone.
white non insulated zone Black insulated zone and red is the ablation zone.
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                                         Techniques
1. Perithyroidal lidocaine injection ( the thyroid capsule)
    Effective in Minimizing pain during the procedure.
    Collected lidocaine appears as an anechoic band (arrows)
    separating the thyroid gland and the strap muscle.
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2. Vascular ablation techniques
       Artery ablation: For hypervascular nodules with feeding
                                     arteries near the isthmus
      Marginal venous ablation:  Helpful in preventing marginal tumor recurrence.
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Artery first ablation arrows showing the microbubbles filling the arterioles.
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3. Hydrodissection terchnique  ( Dextrose Infusion )
    Effective is separating tumor from adjacent critical structure.
     A needle of syringe with 5% dextrose inserted behind the recurrent nerve.
     Slow injection of dextrose between target tumor and critical structures
     recurrent nerve,esophagus, and trachea.
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Picture of Professor JH Baek MD,Phd who lead the way with these devices and techniques to make RFA safer for thyroid work in the danger loaded neck area.
Call Matt at 310-393-8860 or thyroid.manager@protonmail.com for patient information of treatment options and for endocrinologists to obtain details of my master’s class in thyroid ablation. Ethanol and radiofrequency 3-5 day workshop.
Richard Guttler MD,FACE,ECNU
thyroid.com
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