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Jack W Jennings - One of the best experts on this subject based on the ideXlab platform.
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Combination acetabular Radiofrequency Ablation and cementoplasty using a navigational Radiofrequency Ablation Device and ultrahigh viscosity cement: technical note
Skeletal Radiology, 2016Co-Authors: Adam N. Wallace, Ambrose J. Huang, Devin Vaswani, Randy O. Chang, Jack W JenningsAbstract:Background Percutaneous Radiofrequency Ablation and cementoplasty is an alternative palliative therapy for painful metastases involving axial load-bearing bones. This technical report describes the use of a navigational Radiofrequency probe to ablate acetabular metastases from an anterior approach followed by instillation of ultrahigh viscosity cement under CT-fluoroscopic guidance. Materials and methods The tumor Ablation databases of two institutions were retrospectively reviewed to identify patients who underwent combination acetabular Radiofrequency Ablation and cementoplasty using the STAR Tumor Ablation and StabiliT Vertebral Augmentation Systems (DFINE; San Jose, CA). Pre-procedure acetabular tumor volume was measured on cross-sectional imaging. Pre- and post-procedure pain scores were measured using the Numeric Rating Scale (10-point scale) and compared. Partial pain improvement was categorically defined as ≥ 2-point pain score reduction. Patients were evaluated for evidence of immediate complications. Electronic medical records were reviewed for evidence of delayed complications. Results During the study period, 12 patients with acetabular metastases were treated. The median tumor volume was 54.3 mL (range, 28.3–109.8 mL). Pre- and post-procedure pain scores were obtained from 92 % (11/12) of the cohort. The median pre-procedure pain score was 8 (range, 3–10). Post-procedure pain scores were obtained 7 days (82 %; 9/11), 11 days (9.1 %; 1/11) or 21 days (9.1 %; 1/11) after treatment. The median post-treatment pain score was 3 (range, 1–8), a statistically significant difference compared with pre-treatment ( P = 0.002). Categorically, 73 % (8/11) of patients reported partial pain relief after treatment. No immediate symptomatic complications occurred. Three patients (25 %; 3/12) were discharged to hospice within 1 week of treatment. No delayed complications occurred in the remaining 75 % (9/12) of patients during median clinical follow-up of 62 days (range, 14–178 days). Conclusions Palliative percutaneous acetabular Radiofrequency Ablation and cementoplasty can be feasibly performed from an anterior approach using a navigational Ablation probe and ultrahigh viscosity cement instilled under CT-fluoroscopic guidance.
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combination acetabular Radiofrequency Ablation and cementoplasty using a navigational Radiofrequency Ablation Device and ultrahigh viscosity cement technical note
Skeletal Radiology, 2016Co-Authors: Adam N. Wallace, Ambrose J. Huang, Devin Vaswani, Randy O. Chang, Jack W JenningsAbstract:Background Percutaneous Radiofrequency Ablation and cementoplasty is an alternative palliative therapy for painful metastases involving axial load-bearing bones. This technical report describes the use of a navigational Radiofrequency probe to ablate acetabular metastases from an anterior approach followed by instillation of ultrahigh viscosity cement under CT-fluoroscopic guidance.
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treatment of metastatic posterior vertebral body osseous tumors by using a targeted bipolar Radiofrequency Ablation Device technical note
Radiology, 2014Co-Authors: Travis J Hillen, Praveen Anchala, Michael V Friedman, Jack W JenningsAbstract:The articulating Radiofrequency Ablation Device provides access to posterior vertebral body tumors that were difficult to access previously by using conventional Ablation Devices and allows for safe and controlled Ablation of posterior vertebral body tumors without thermal nerve injury.
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treatment of metastatic spinal lesions with a navigational bipolar Radiofrequency Ablation Device a multicenter retrospective study
Pain Physician, 2014Co-Authors: Praveen Anchala, Travis J Hillen, Michael V Friedman, Winston D Irving, Bassem A Georgy, Douglass M Coldwell, Nam D Tran, Frank D Vrionis, Allan L Brook, Jack W JenningsAbstract:BACKGROUND: Spinal metastatic lesions are a common occurrence among oncology patients and contribute to significant morbidity. Treatment options have been limited in their effectiveness and scope to this point. OBJECTIVE: This study aims to report the safety and efficacy of Radiofrequency Ablation (RFA) of malignant spinal lesions using a novel RFA bipolar tumor Ablation system which includes a navigational electrode containing 2 active thermocouples. STUDY DESIGN: IRB approved multicenter retrospective review of patients receiving RFA as a treatment of metastatic osseous lesions between March 2012 and March 2013. SETTING: This study consists of patients from 5 large academic centers. METHOD: One hundred twenty-eight metastatic lesions were identified in 92 patients who underwent a total of 96 procedures. Cement augmentation was performed when the vertebral body was at risk or had a pathological fracture. Visual analogue scale (VAS) scores were obtained preoperatively as well as postoperatively at the one week, one month, and 6 month time points. Interval change in the patients' pain medications was recorded. Postoperative imaging was used to assess tumor burden at the treated level when available. RESULTS: RFA was technically successful in all of the lesions without complication or thermal injury. Our study demonstrated significant (P < 0.01) decreases in the VAS scores at one week, one month, and 6 months postoperatively. In our largest center, 54% of our patients experienced a decrease and 30% had no change in their pain medications postoperatively. Sixty-two percent of the spinal lesions in this largest institution were located in the posterior vertebral body. Post-Ablation imaging confirmed size of Ablation zones consistent with that measured by the thermocouples. LIMITATIONS: The main limitations of this study are the heterogeneous patient population, data set, and potential confounding variable of concurrent cement augmentation. CONCLUSION: The STAR System is an RFA Device that was safely and effectively used in the treatment of spine metastatic osseous lesions. This new Device allows RFA treatment of previously untreatable lesions with resultant reduction in pain that was not controlled by systemic or radiation therapy.
Ralph J Damiano - One of the best experts on this subject based on the ideXlab platform.
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performance of a novel bipolar monopolar Radiofrequency Ablation Device on the beating heart in an acute porcine model
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, 2013Co-Authors: Lindsey L Saint, Richard B Schuessler, Christopher P Lawrance, Shoichi Okada, Toshinobu Kazui, Jason O Robertson, Ralph J DamianoAbstract:ObjectiveAlthough the advent of Ablation technology has simplified and shortened surgery for atrial fibrillation, only bipolar clamps have reliably been able to create transmural lesions on the bea...
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Performance of a novel bipolar/monopolar Radiofrequency Ablation Device on the beating heart in an acute porcine model.
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, 2013Co-Authors: Lindsey L Saint, Richard B Schuessler, Christopher P Lawrance, Shoichi Okada, Toshinobu Kazui, Jason O Robertson, Ralph J DamianoAbstract:ObjectiveAlthough the advent of Ablation technology has simplified and shortened surgery for atrial fibrillation, only bipolar clamps have reliably been able to create transmural lesions on the bea...
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chronic performance of a novel Radiofrequency Ablation Device on the beating heart limitations of conduction delay to assess transmurality
The Journal of Thoracic and Cardiovascular Surgery, 2012Co-Authors: Abdulhameed Aziz, Richard B Schuessler, Kal L Clark, Ralph J DamianoAbstract:Objective The creation of consistently transmural lesions with epicardial Ablation on the beating heart has represented a significant challenge for current technology. This study examined the chronic performance of the AtriCure Coolrail Device (AtriCure Inc, West Chester, Ohio), an internally cooled, bipolar Radiofrequency Ablation Device designed for off-pump epicardial Ablation. The study also examined the reliability of using acute intraoperative conduction delay to evaluate lesion integrity. Methods Seven swine underwent median sternotomy. The right atrial appendage and inferior vena cava were isolated with a bipolar Radiofrequency clamp. Linear Ablation lines were created between these structures with the AtriCure Coolrail. Paced activation maps were recorded with epicardial patch electrodes acutely before and after Ablation and after keeping the animals alive for 4 weeks. The conduction time across the linear Ablation was calculated from these maps. The lesions were histologically evaluated with trichrome staining. Results Only 76% of cross-sections of Coolrail lesions were transmural, and only 1 of 12 Ablation lines was transmural in every cross-section examined. Mapping data were available in 5 of the animals. Significant conduction delay was present after the creation of each line of Ablation acutely; however, after 4 weeks, conduction time returned to preAblation values, demonstrating lack of transmurality. Conclusions The AtriCure Coolrail failed to reliably create transmural lesions. Although the Coolrail was able to create acute conduction delay, its failure to transmurally ablate the atrial myocardium left gaps along the length of the lesion, which resulted in neither chronic conduction block nor delay across any line of Ablation.
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performance of a novel dual electrode bipolar Radiofrequency Ablation Device a chronic porcine study
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, 2011Co-Authors: Rochus K Voeller, Andreas Zierer, Richard B Schuessler, Ralph J DamianoAbstract:OBJECTIVE: : Over recent years, a variety of energy sources, including bipolar Radiofrequency, have been used to replace the traditional incisions of the Cox-Maze procedure for the surgical treatment of atrial fibrillation (AF). The purpose of this study was to evaluate the safety and efficacy of a novel dual-electrode bipolar Radiofrequency Ablation Device Synergy (Atricure, Inc., Cincinnati, OH USA) for AF in a chronic porcine model. METHODS: : Six domestic pigs underwent a modified Cox-Maze IV procedure without cardiopulmonary bypass using the Synergy Device. Animals survived for 30 days. Each pig then underwent induction of AF and was killed to remove the heart en bloc for histologic assessment. Each Ablation line was dissected perpendicularly at 5-mm intervals to assess the lesion width, depth, and transmurality. RESULTS: : All animals survived the operation. Electrical isolation of the left atrial appendage and the pulmonary veins were documented by pacing acutely and at 30 days after the operation in all six animals. All animals failed to be induced in AF at 30 days. There was no gross evidence of intra-atrial thrombus formation or stricture of the pulmonary veins. All Ablations (n = 209) examined were discrete, linear, and transmural, with a mean lesion width of 3.0 ± 0.7 mm and a mean lesion depth of 5.4 ± 3.3 mm. The mean Ablation time was 16.3 ± 4.4 seconds, with a mean total energy delivery of 238 ± 170 J. CONCLUSIONS: : The Atricure Synergy was able to create reliable chronic transmural lesions of the modified Cox-Maze IV procedure on a porcine beating heart without cardiopulmonary bypass. The Ablation lines were significantly wider when compared with its predecessor, the Isolator II.
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efficacy of a novel bipolar Radiofrequency Ablation Device on the beating heart for atrial fibrillation Ablation a long term porcine study
The Journal of Thoracic and Cardiovascular Surgery, 2010Co-Authors: Rochus K Voeller, Andreas Zierer, Richard B Schuessler, Shelly C Lall, Shunichiro Sakamoto, Ralph J DamianoAbstract:Objective Over recent years, a variety of energy sources have been used to replace the traditional incisions of the Cox maze procedure for the surgical treatment of atrial fibrillation. This study evaluated the safety and efficacy of a new bipolar Radiofrequency Ablation Device for atrial Ablation in a long-term porcine model. Methods Six pigs underwent a Cox maze IV procedure on a beating heart off cardiopulmonary bypass using the AtriCure Isolator II bipolar Ablation Device (AtriCure, Inc, Cincinnati, Ohio). In addition, 6 pigs underwent median sternotomy and pericardiotomy alone to serve as a control group. All animals were allowed to survive for 30 days. Each pig underwent induction of atrial fibrillation and was then humanely killed to remove the heart en bloc for histologic assessment. Magnetic resonance imaging scans were also obtained preoperatively and postoperatively to assess atrial and ventricular function, pulmonary vein anatomy, valve function, and coronary artery patency. Results All animals survived the operation. Electrical isolation of the left atrial appendage and the pulmonary veins was documented by pacing acutely and at 30 days in all animals. No animal that underwent the Cox maze IV procedure was able to be induced into atrial fibrillation at 30 days postoperatively, compared with all the sham animals. All 257 Ablations examined were discrete, linear, and transmural, with a mean lesion width of 2.2 ± 1.1 mm and a mean lesion depth of 5.3 ± 3.0 mm. Conclusions The AtriCure Isolator II Device was able to create reliable long-term transmural lesions of the modified Cox maze procedure on a beating heart without cardiopulmonary bypass 100% of the time. There were no discernible effects on ventricular or valvular function.
David L Morris - One of the best experts on this subject based on the ideXlab platform.
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hand assisted laparoscopic partial nephrectomy a controlled study of bipolar inline Radiofrequency Ablation Device in swine
Surgical Innovation, 2010Co-Authors: Ray Stanton, Aravin Gunasegaram, Leigh A Ladd, Terence C Chua, Michael Wines, David L MorrisAbstract:BACKGROUND: Bipolar inline Radiofrequency Ablation (ILRFA) is an effective way to control bleeding during parenchymal organ transection. This was investigated in a study of laparoscopic hand-assisted partial nephrectomy in swine. METHODS: Nine Landrace pigs were divided between 2 groups; diathermy was employed in the control group for parenchymal transaction and ILRFA was applied in the experimental group through a hand-port and deployed into the resection plane. After complete coagulation, resection was performed using scissors. RESULTS: The mean intraoperative blood loss was 32 +/- 15 mL in the ILRFA group and 187 +/- 69 mL in the control group: a 82.9% reduction ( P = .015). The mean blood loss per resection area was 2.53 +/- 0.92 mL/cm(2) in the ILRFA group compared with 17.31 +/- 9.05 mL/cm( 2) in controls; the reduction was 85.4% (P = .005). CONCLUSIONS: ILRFA is effective in achieving reducing blood loss and provides a drier operative field for precise dissection.
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inline bipolar Radiofrequency Ablation Device assisted partial nephrectomy in a porcine model
Anz Journal of Surgery, 2008Co-Authors: Aravin Gunasegaram, Leigh A Ladd, David L MorrisAbstract:Background: Nephron-sparing surgery has become an acceptable alternative to radical nephrectomy in the treatment of renal tumours. Control of intraoperative blood loss can be an important challenge during partial nephrectomy. InLine Radiofrequency Ablation (ILRFA) Device has shown promising results of significant reduction of intraoperative blood loss in liver resection. In this study, we tested ILRFA-assisted partial nephrectomy in a porcine model. Methods: Eight landrace pigs were used in this study. Every pig underwent 2–3 partial nephrectomies. The proposed line of parenchymal incision was circumferentially scored with a diathermy. Then, ILRFA was deployed into this resection plane. After complete coagulation, the resection was then simply carried out using the scalpel. For the control resection, we used diathermy to transect the other pole, further sutures were then used to secure the residual bleeding. Results: The ILRFA deployments were set to 3 cm power algorithm. The average Radiofrequency Ablation coagulation time was 5 min. The mean intraoperative blood loss 35 ± 7 mL in the ILRFA and 152 ± 94 mL in the control, a 77.0% reduction (P = 0.024). The mean blood loss per centimetre of resection area was 2.09 ± 1.41 mL/cm2 in the ILRFA compared with 12.79 ± 1.68 mL/cm2 in controls; the reduction was 79.0% (P = 0.019). Conclusion: Our study indicates that ILRFA for partial nephrectomy in a porcine model is effective in reducing blood loss. Precoagulation before parenchymal transection appears to be a valid concept in nephron-sparing surgery.
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Novel surgical management of renal trauma: InLine Radiofrequency Ablation coagulation.
Anz Journal of Surgery, 2008Co-Authors: Aravin Gunasegaram, Leigh A Ladd, David L MorrisAbstract:Background: Renal injury accounts for 10% of all abdominal trauma. Low-grade renal injuries can be managed without surgery. However, patients with grade IV or grade V injuries may require nephrectomy. In this study, InLine Radiofrequency Ablation Device (ILRFA), which we developed for liver surgery was tested in the animal model of simulated renal injury. Methods: A grade IV renal injury was induced in eight landrace pigs. Then treatment with ILRFA was compared to conventional diathermy and suture; totally 24 surgeries were carried out (12 ILRFA vs 12 control). Results: No massive bleeding occurred and no animal died during the experiments. Immediately after surgery, the pigs were given euthanasia. The average of RFA coagulation time was 3.5 min. The mean intraoperative blood loss was 42 ± 16 mL in the ILRFA and 195 ± 58 mL in the control, a 78.5% reduction (P
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a multicentre controlled study of the inline Radiofrequency Ablation Device for liver transection
Hpb, 2007Co-Authors: Steve Daniel, Aravin Gunasegaram, W. Lindemann, Georg Pistorius, Martin K. Schilling, Junji Machi, Randall Zuckerman, David L MorrisAbstract:Background. Surgical resection is the most effective therapy for liver cancer. Intraoperative blood loss during liver resection remains a major concern due to association with higher postoperative complications. The InLine Radiofrequency Ablation Device (ILRFA) has achieved promising results in liver surgery with minimal blood loss and no increase of postoperative complications. In this multicentre controlled study, 108 patients undergoing liver resection were investigated. Patients and methods. A total of 108 patients underwent liver resections in 4 medical centres; the prospective sequential cohort study consisted of 54 ILRFA and 54 ultrasonic surgical aspirator transections as the control group. Results. The type of liver resection performed was very similar in both groups. The median number of RFA deployments was 3 (range 1–12) with a median coagulation time of 9 (range 3–36) min. Median blood loss was 165±20 ml (range 5–675) in the ILRFA and 654±83 ml (range 80–3600) in the control group (p<0.001). The median transection time was 27 (2–219) min in the ILRFA group and 35 (5–62) min in controls. Conclusions. Our study indicates that ILRFA Device for liver transection is effective in reducing blood loss and is safe. Precoagulation before parenchymal transection appears to be a valid concept in liver surgery. The avoidance of vascular inflow occlusion during parenchymal transection could also be of value.
Richard B Schuessler - One of the best experts on this subject based on the ideXlab platform.
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performance of a novel bipolar monopolar Radiofrequency Ablation Device on the beating heart in an acute porcine model
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, 2013Co-Authors: Lindsey L Saint, Richard B Schuessler, Christopher P Lawrance, Shoichi Okada, Toshinobu Kazui, Jason O Robertson, Ralph J DamianoAbstract:ObjectiveAlthough the advent of Ablation technology has simplified and shortened surgery for atrial fibrillation, only bipolar clamps have reliably been able to create transmural lesions on the bea...
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Performance of a novel bipolar/monopolar Radiofrequency Ablation Device on the beating heart in an acute porcine model.
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, 2013Co-Authors: Lindsey L Saint, Richard B Schuessler, Christopher P Lawrance, Shoichi Okada, Toshinobu Kazui, Jason O Robertson, Ralph J DamianoAbstract:ObjectiveAlthough the advent of Ablation technology has simplified and shortened surgery for atrial fibrillation, only bipolar clamps have reliably been able to create transmural lesions on the bea...
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chronic performance of a novel Radiofrequency Ablation Device on the beating heart limitations of conduction delay to assess transmurality
The Journal of Thoracic and Cardiovascular Surgery, 2012Co-Authors: Abdulhameed Aziz, Richard B Schuessler, Kal L Clark, Ralph J DamianoAbstract:Objective The creation of consistently transmural lesions with epicardial Ablation on the beating heart has represented a significant challenge for current technology. This study examined the chronic performance of the AtriCure Coolrail Device (AtriCure Inc, West Chester, Ohio), an internally cooled, bipolar Radiofrequency Ablation Device designed for off-pump epicardial Ablation. The study also examined the reliability of using acute intraoperative conduction delay to evaluate lesion integrity. Methods Seven swine underwent median sternotomy. The right atrial appendage and inferior vena cava were isolated with a bipolar Radiofrequency clamp. Linear Ablation lines were created between these structures with the AtriCure Coolrail. Paced activation maps were recorded with epicardial patch electrodes acutely before and after Ablation and after keeping the animals alive for 4 weeks. The conduction time across the linear Ablation was calculated from these maps. The lesions were histologically evaluated with trichrome staining. Results Only 76% of cross-sections of Coolrail lesions were transmural, and only 1 of 12 Ablation lines was transmural in every cross-section examined. Mapping data were available in 5 of the animals. Significant conduction delay was present after the creation of each line of Ablation acutely; however, after 4 weeks, conduction time returned to preAblation values, demonstrating lack of transmurality. Conclusions The AtriCure Coolrail failed to reliably create transmural lesions. Although the Coolrail was able to create acute conduction delay, its failure to transmurally ablate the atrial myocardium left gaps along the length of the lesion, which resulted in neither chronic conduction block nor delay across any line of Ablation.
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performance of a novel dual electrode bipolar Radiofrequency Ablation Device a chronic porcine study
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, 2011Co-Authors: Rochus K Voeller, Andreas Zierer, Richard B Schuessler, Ralph J DamianoAbstract:OBJECTIVE: : Over recent years, a variety of energy sources, including bipolar Radiofrequency, have been used to replace the traditional incisions of the Cox-Maze procedure for the surgical treatment of atrial fibrillation (AF). The purpose of this study was to evaluate the safety and efficacy of a novel dual-electrode bipolar Radiofrequency Ablation Device Synergy (Atricure, Inc., Cincinnati, OH USA) for AF in a chronic porcine model. METHODS: : Six domestic pigs underwent a modified Cox-Maze IV procedure without cardiopulmonary bypass using the Synergy Device. Animals survived for 30 days. Each pig then underwent induction of AF and was killed to remove the heart en bloc for histologic assessment. Each Ablation line was dissected perpendicularly at 5-mm intervals to assess the lesion width, depth, and transmurality. RESULTS: : All animals survived the operation. Electrical isolation of the left atrial appendage and the pulmonary veins were documented by pacing acutely and at 30 days after the operation in all six animals. All animals failed to be induced in AF at 30 days. There was no gross evidence of intra-atrial thrombus formation or stricture of the pulmonary veins. All Ablations (n = 209) examined were discrete, linear, and transmural, with a mean lesion width of 3.0 ± 0.7 mm and a mean lesion depth of 5.4 ± 3.3 mm. The mean Ablation time was 16.3 ± 4.4 seconds, with a mean total energy delivery of 238 ± 170 J. CONCLUSIONS: : The Atricure Synergy was able to create reliable chronic transmural lesions of the modified Cox-Maze IV procedure on a porcine beating heart without cardiopulmonary bypass. The Ablation lines were significantly wider when compared with its predecessor, the Isolator II.
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efficacy of a novel bipolar Radiofrequency Ablation Device on the beating heart for atrial fibrillation Ablation a long term porcine study
The Journal of Thoracic and Cardiovascular Surgery, 2010Co-Authors: Rochus K Voeller, Andreas Zierer, Richard B Schuessler, Shelly C Lall, Shunichiro Sakamoto, Ralph J DamianoAbstract:Objective Over recent years, a variety of energy sources have been used to replace the traditional incisions of the Cox maze procedure for the surgical treatment of atrial fibrillation. This study evaluated the safety and efficacy of a new bipolar Radiofrequency Ablation Device for atrial Ablation in a long-term porcine model. Methods Six pigs underwent a Cox maze IV procedure on a beating heart off cardiopulmonary bypass using the AtriCure Isolator II bipolar Ablation Device (AtriCure, Inc, Cincinnati, Ohio). In addition, 6 pigs underwent median sternotomy and pericardiotomy alone to serve as a control group. All animals were allowed to survive for 30 days. Each pig underwent induction of atrial fibrillation and was then humanely killed to remove the heart en bloc for histologic assessment. Magnetic resonance imaging scans were also obtained preoperatively and postoperatively to assess atrial and ventricular function, pulmonary vein anatomy, valve function, and coronary artery patency. Results All animals survived the operation. Electrical isolation of the left atrial appendage and the pulmonary veins was documented by pacing acutely and at 30 days in all animals. No animal that underwent the Cox maze IV procedure was able to be induced into atrial fibrillation at 30 days postoperatively, compared with all the sham animals. All 257 Ablations examined were discrete, linear, and transmural, with a mean lesion width of 2.2 ± 1.1 mm and a mean lesion depth of 5.3 ± 3.0 mm. Conclusions The AtriCure Isolator II Device was able to create reliable long-term transmural lesions of the modified Cox maze procedure on a beating heart without cardiopulmonary bypass 100% of the time. There were no discernible effects on ventricular or valvular function.
Ponnandai Somasundar - One of the best experts on this subject based on the ideXlab platform.
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initial experience using a bipolar Radiofrequency Ablation Device for hemostasis during thyroidectomy
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2013Co-Authors: Keith Baldwin, Michelle Haniff, Ponnandai SomasundarAbstract:Background The purpose of this study was to evaluate a novel bipolar Radiofrequency Ablation (BRFA) Device using nanotechnology for division of all named vessels during thyroidectomy. Methods All thyroidectomies from January 2008 to July 2010 at a single institution used the BRFA Device (EnSeal, Ethicon Endo-Surgery, Cincinnati, OH) for hemostasis. Clinicopathologic data and complications were recorded and compared with existing literature using other energy Devices. Results Fifty-eight thyroidectomies were performed. Mean age was 54.7 years, and mean operating room time was 81 minutes. The average estimated blood loss was 46 mL. Ninety percent of patients were discharged in <23 hours. There were no hemorrhages. There was 1 recurrent laryngeal nerve (RLN) injury, and 1 case of transient hypocalcemia. Conclusion This first small series using the BRFA Device reveals initial safety and effectiveness for thyroid hemostasis, and warrants further study. The minimal thermal spread inherent in this Device may make it an attractive option when structures such as the RLN may be near the zone of hemostasis. © 2012 Wiley Periodicals, Inc. Head Neck, 2013
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Initial experience using a bipolar Radiofrequency Ablation Device for hemostasis during thyroidectomy.
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2012Co-Authors: Keith Baldwin, Michelle Haniff, Ponnandai SomasundarAbstract:Background The purpose of this study was to evaluate a novel bipolar Radiofrequency Ablation (BRFA) Device using nanotechnology for division of all named vessels during thyroidectomy. Methods All thyroidectomies from January 2008 to July 2010 at a single institution used the BRFA Device (EnSeal, Ethicon Endo-Surgery, Cincinnati, OH) for hemostasis. Clinicopathologic data and complications were recorded and compared with existing literature using other energy Devices. Results Fifty-eight thyroidectomies were performed. Mean age was 54.7 years, and mean operating room time was 81 minutes. The average estimated blood loss was 46 mL. Ninety percent of patients were discharged in