Comparing the safety of harmonic ACE and ACE+ around the recurrent laryngeal nerve in swine models.
10.4174/astr.2018.94.6.285
- Author:
Hong Kyu KIM
1
;
Young Jun CHAI
;
Hye Yoon LEE
;
Hoon Yub KIM
;
Gianlorenzo DIONIGI
Author Information
1. Department of Surgery, KUMC Thyroid Center, Korea University Hospital, Korea University College of Medicine, Seoul, Korea. hoonyubkim@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Thyroid;
Recurrent laryngeal nerve;
Neuromonitoring
- MeSH:
Recurrent Laryngeal Nerve*;
Surgeons;
Swine*;
Thyroid Gland;
Ultrasonics
- From:Annals of Surgical Treatment and Research
2018;94(6):285-290
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Among the various energy-based devices, ultrasonic shears are popular in thyroid surgeries. In this study, we tested the safety of Harmonic ACE and Harmonic ACE+ around the recurrent laryngeal nerve (RLN) in experimental swine models. METHODS: Harmonic ACE and Harmonic ACE+ were each tested in 4 piglets. Harmonic ACE and Harmonic ACE+ were activated at a 0- to 5-mm distance from the RLN. The function of the RLN was assessed using continuous electrophysiological monitoring. RESULTS: For Harmonic ACE, there was no adverse EMG event found when activated at 4- and 5-mm distances from the RLN. At a 2- to 3-mm distance, there were 4 adverse EMG events observed. In these 4 cases, adjacent tissue shrinkage occurred after 6 to 15 seconds of activation, and the RLN touched the Harmonic ACE. At a 1-mm distance, there were 2 adverse EMG events found after 25 seconds of activation. For Harmonic ACE+, there was no adverse EMG event observed when activated at 1- and 3-mm distances from the RLN. At a 0-mm distance, 2 adverse EMG events occurred after 6 to 10 seconds of activation. CONCLUSION: The safe distance of Harmonic ACE and ACE+ was 4 and 1 mm, respectively, in the swine models. Harmonic ACE+ is safer than Harmonic ACE because it did not cause any tissue shrinkage. Surgeons need to understand the characteristics of devices for safe operation.
