Thyroid Radiofrequency Ablation Course

Thyroid Radiofrequency Ablation Course

Thyroid Radiofrequency Ablation Course

                  Thyroid Radiofrequency Ablation Course

Santa Monica Thyroid Center


Richard Guttler MD,FACE,ECNU

Interventional Thyroidologist


Radiofrequency Thyroid Tumor Ablation Workshop

For Endocrinologists


Day One

Morning 8-12

Introduction to thyroid tumor ablation

Lectures on present state of RFA in the world

Lecture on the RFA literature, Uses and


SOP for doing RFA in your endocrine practice office.

List of equipment needed including the electrode

and generator.

“Knobology” How to use of generator, cooling pump, grounding pads and electrodes.

Afternoon 12:30-6PM

Workshop continues

Prepare models for RFA practice when you get your generator.

Bovine Liver with assorted size “beef” nodules

Nodules sewn in to pockets in the liver.

Simulating thyroid nodules and primary

Micro-papillary and lymph node cancers and parathyroid adenoma.

The RFA ultrasound room set up.

Ice saline cooling pump to cool the electrode.

Grounding pads for monopolar electrodes.

Why are they needed?

Proper placement of the grounding pads to prevent skin burns.

Generator 101 the basics.

3, 5, 7 and 10 mm hot tips on an #18 or 19 electrode.

High resolution Ultrasound to monitor the

tip during the treatment. ultrasound anatomy of the neck structures including nerves and blood vessels.

Mark the inferior and superior extent of the “beef nodule.

Mark the middle with an X. This is the entry point for the electrode.

Begin RFA practice with 10, 20, 30 ml “beef nodules”.

Learn how to use lidocaine on the peri-thyroid capsular space

with water injection of “capsule simulation” on a water balloon or “beef nodule”

Use the original insertion hole at the X to inject the capsule to put the electrode into the nodule at the isthmus.

Learn how to use microdissection with dextrose infusion to move the nodule away from dangerous structures. Recurrent nerve etc.

Learn “moving shot” technique by practice on Ace Needle ME

torso and on Bovine liver.

Learn how to avoid the danger triangle.

Protocol for RFA ablation begins with electrode

positioning at the inferior posterior of the “nodule”

Foot pedal controls the on/off of the hot tip.

Iced saline is continuously circulating around the tip.

With the electrode in position turn on the heat.

Usually 20-50 watts is all you need to ablation

the “beef nodule”.

Now slowly pull the electrode back

under complete US vision until you have ablated this area.

Turn off and re-position to the anterior position away

from the micro-bubbles formed posterity.

Turn on and do the anterior section.

Continue this without removing the electrode from the nodule.

Also make sure the electrode is off 5 mm from the capsule to prevent nodule rupture.

Repeat the same to the middle of the nodule

and then the Superior part of the nodule.

The “beef nodule” ablated is removed and dissected to see how well you did with your first try. Continue on the other

Beef nodules and small “lymph nodes and micro-cancer “nodules.

Practice doing a “ beef parathyroid adenoma” with hydro-dissection.

Never use saline during a real case as saline conducts electricity.

After you are done again dissect the nodules to see the

Ablated areas in the nodule are not through nodule surface.


Day Two

All day workshop

Morning 8-12


Practice Everything learned on Day One

RFA practice technique

Lidocaine capsule method

Hydro-dissection Method with dextrose.

Thyroid nodules

Cancer lymph nodes

Primary micro-papillary

thyroid cancer

Parathyroid adenoma


Afternoon 1-4


Observation of 1-2 actual cases done by Dr.Guttler


Final review and questions


Master’s class Diploma ( No CME )

$2000 fee

Call Alicia at 310-393-8860 or [email protected]



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Contact Info
1328 16th Street, Santa Monica, CA 90404
Monday – Friday
9:00 AM to 5:00 PM
(310) 393-8860