Thermal effects of the Thunderbeat device on the recurrent laryngeal nerve during thyroid surgery

Surg Today. 2018 Dec;48(12):1076-1080. doi: 10.1007/s00595-018-1692-1. Epub 2018 Jul 9.

Abstract

Purpose: To investigate the safety of the Thunderbeat (TB) device in thyroid surgery by clarifying its thermal effects on the recurrent laryngeal nerve (RLN).

Methods: We performed thyroidectomy using TB on four female pigs under general anesthesia. TB was applied 0, 1, and 2 mm from the RLN. The effects of incisions made in tissues in the vicinity of the RLN were evaluated by intraoperative neuromonitoring and pathological examination.

Results: The value of the neural integrity monitor (NIM) was unchanged at 2 and 1 mm, but there was loss of signal at 0 mm. The differences between 2 and 0 mm were not clear from the pathological findings.

Conclusions: When using the TB device during thyroid surgery, it is recommended that it is visually kept from making any contact with the RLN.

Keywords: Energy-based devices; Intraoperative monitoring; Recurrent laryngeal nerve palsy; Thermal effects; Thyroidectomy.

MeSH terms

  • Animals
  • Equipment Safety
  • Female
  • Hot Temperature / adverse effects*
  • Intraoperative Complications / etiology*
  • Intraoperative Complications / prevention & control*
  • Monitoring, Intraoperative
  • Recurrent Laryngeal Nerve*
  • Surgical Instruments / adverse effects*
  • Swine
  • Thyroidectomy / instrumentation*
  • Vocal Cord Paralysis / etiology*
  • Vocal Cord Paralysis / prevention & control*