Dr.Guttler’s comments: To prevent this serious complication, make sure you absolutely need the surgery. A total of 1000 RLNs from 574 patients were assessed in this review. Nearly one-quarter (23%) of the RLNs deviated from their...More info
2022 The Indication For Thyroid Surgery Decreases Further Due to Novel Ablation Procedures For Benign and Thyroid Tumors
Thyroid 32(1) 2022 Tufano RP et al “The year of technical advances in treating nodules and cancer” Dr.Guttler’s comments on this special article on thyroid advances. The number of surgeries for benign nodules has shown a...More info
Thyroid No Surgery: List of All Diseases With Low Risk Alternative Ablation Therapy Available at My Center
Benign thyroid nodules class 11 are good candidates for Ablation. However, Class III will need more studies to be sure you don’t have a nodule with potential for thyroid cancer. A suspicious needle biopsy alone can lead to unnecessary...More info
Continuous Infusion of Dextrose to Protect Vital Structures During Thyroid Radiofrequency Ablation Procedures.
When do we need to use continuous infusion D5W for adequate hydrodissection protective effects? Ma Y. et al Eur. Thyroid Journal October 2021 DR. Guttler’s Comments on the article: Single bolus of D5W has a short half life in the body...More info
Endocrine Practice 27(2021) 1205-1211 Tufano R. et al DR.Guttler’s Comments: 25 patients were treated with RFA for PTA. 29 enlarged glands were RFA treated. 22 had one session. 3 had 2 sessions. 84% cure rate. 12 month volume reduction in...More info
The Gold Rush is ON. Every University, Hospital, Imaging Center, Radiologist, Surgeon is Now Offering Thyroid Radiofrequency Ablation RFA for Nodules.
In 2014 there were none of the above learning thyroid RFA. Only Koreans, and Europeans such as Dr.Baek in Korea and Dr.Valcavi in Italy. After traveling to Italy in 2014, I returned to the US and began to work with RFA systems and to teach...More info
Is Thyroidectomy Still the gold standard for all thyroid nodules,cancer, and metastatic lymph nodes?
20 years of image guided interventional methods have emerged as alternatives for treatment. Ethanol ablation PEI has been accepted as best treatment for thyroid cysts. Thermal ablation has been successful in size reduction of thyroid nodules that...More info
RFA is a game changer for your thyroid patients who want to avoid surgery, the scar and the need for lifetime thyroid medication. RFA is a new procedure that clinical and interventional thyroidologists need to learn. RFA out-competes surgery and...More info
Use of a local to the thyroid capsule is all that is needed to control pain. The capsule has sensory nerve endings.The interior of the thyroid and nodules have no sensory nerves. The patient when awake can tell the operator if they have pain, and...More info
Thyroid RFA Danger Zones: Not just the “danger triangle”The whole Posterior half of the thyroid gland is a danger area.
Where are the critical Structures? 1.A medial located vagus nerve can be up against the nodule. It is usually located lateral to the carotid in 75%. The middle cervical sympathetic ganglion also can be near the nodule. Recurrent laryngeal nerve...More info
DR.Guttler’s comments: A study with 10 patients with hypercalcemia due to adenoma treated with RFA and followed for 6 months.. 7/10 had normal PTH and Calcium for 6 months. 1/10 died of pancreatitis. 2/10 lost to F/U before the 6 th month...More info