Novel Teaching Methods for Endocrinologists to Learn Thyroid RFA:
Master’s Class in Thyroid Tumor Ablation
Ethanol and RFA Ablation
Richard B.Guttler MD,FACE,ECNU
RFA Section of the class
Thyroid Radiofrequency Ablation Teaching Methods
RFA Teaching Methods, Materials and Techniques
- Super-concentrated Gelatin Phantom suspension system for nodules and for dextrose separation technique. Straws filled with conduction gel for danger blood vessels during dextrose infusion technique.
- Gelatin Model Reference:
Thyroid (24)11,2014 1662–3
Dev Abraham MD,MRCP(UK),ECNU
- RFA done on either Bovine Liver with Beef “nodules” inserted, or beef nodules inserted into cooled supersaturated gelatin for a more sanitary workshop.
- Thyroid RF System: The Generator
- Grounding Pads for Unipolar Electrodes
- Thyroid Friendly Short Thin Electrodes
Standard 10 mm electrode with with smaller tips 3, 5 ,7 mm for lymph nodes cancer and danger triangle work.
- Trans-isthmic Approach
Electrode enters through the avascular isthmus area
- Trans-isthmic Approach Demo neck torso
- Moving Shot Method Taught on Bovine Liver model.
- Gelatin Model Thyroid Capsule Lidocaine injection
- Practice injecting the capsule by using a gelatin model with
a balloon to simulate the thyroid gland capsule.
- Actual Capsule Lidocaine Infusion Method.
- Gelatin Model to Practice Microdissection (Dextrose Avoidance) A target“nodule”on the right is near a danger structure. Needle injects Dextrose to separate them pre-RFA.
- Actual case with arrows showing separation from danger structure.
- Location of nodule near dangerous structures determines the need for microdissection shown in yellow.
- PRE-RFA Arteriole Ablation Near Nodule
Blood vessels are a heat sink and reduce the ability to ablate the nodule. Actual ablation done on an arteriole.
- The 2 day course is climaxed with 1-2 actual patients with benign nodules treated by Dr.Guttler. The course fee is $2000. Call me at 310-393-8860 or email to [email protected] for detailed course outline.
- Endocrinologists with experience doing their own Ultrasounds and biopsies can easily learn Thyroid RFA.
- After my course to actually do a case you need to travel to my colleague’s course in Brazil. Dr.Leonardo Rangel in Rio will allow you to treat one of his patients with his direct control of the heat production with the foot pedal.