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Thyroid Ablation: A Safe and Effective Alternative to Surgery

What makes Thyroid Radio Frequency Ablation the clear choice for treating benign thyroid nodules (TNs)? 

Thyroid RFA can be used to treat various thyroid problems — hyperthyroidism, myoma, cold nodules, hot nodules, small TNs, and large TNs.

And a non-invasive, non-surgical therapy like RF ablation is always better for patients and for medical practitioners.

Let’s explore the unrivaled safety and efficacy of radiofrequency thermal ablation. Plus, learn what tools you need to offer this revolutionary therapy.

Effectiveness and Safety of Thyroid Radio Frequency Ablation

What has clinical medical research shown with regard to RFA being a good alternative to surgery?

Thyroid RFA Offers Fewer Cosmetic Side Effects

Radiofrequency thyroid ablation offers better cosmetic outcomes compared to other procedures and surgery. 

The Journal of Endocrinology and Metabolism performed a 2015 study in which they found that every single patient that underwent RFA had a higher cosmetic score than those that did not. 

Reduced Risk Of Complications

Radiofrequency thermal ablation is proven to reduce thyroid nodule size. In fact, after a 12 month follow up, a study found that it reduced volume by 69%. 

In addition, RFA is a safer way to reduce thyroid volume because every patient in the study improved their compressive symptoms. In 88% of the patients, compressive symptoms completely disappeared. 

This suggests that long term secondary health benefits are superior with RFA. 100% of patients with pre-toxic thyroid nodules were able to eliminate methimazole therapy and 79% of patients had their hyperthyroidism resolved. 

Perhaps most significant in this study is that patients undergoing RFA experienced no major complications and no hospitalizations. When compared with traditional thyroid surgery like thyroidectomies, the increased safety is clear.

Easy Outpatient Therapy

As opposed to surgery, radio frequency ablation is an outpatient procedure. The Clinical Journal of the Society for Endocrinology and the Endocrine Society of Australia performed a 2017 study finding the following:

Thermal therapies don’t just produce persistent TN shrinkage, but also improve local symptoms. It also found it has a lower risk of complications than surgery.

Thyroid RF Thermal Ablation Boasts a 99.8% Recovery Rate From Complications

A study analyzing 1,543 nodules that underwent RFA found that there were only 1.3% major complications and 3.3% overall complications. 

Yet even in the very unlikely scenario that a patient experiences a complication from thermal ablation, the recovery rates speak for themselves. 99.8% of all patients studied recovered spontaneously from complications due to RFA. 

Of the only two patients who did not, one had hypothyroidism, and the other underwent surgery.

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Depth And Breadth Of Clinical Studies

The European Thyroid Journal reviewed almost 20 years of clinical thermoablation use. Over that time, there is zero evidence of RFA techniques causing thyroid neoplasia. 

The journal also confirmed that thyroid RFA has a significantly low rate of both major and minor complications. However, as with anything in medicine, operators should have a dedicated training in image guided thyroid therapy procedures. 

That being said, let’s discuss how to safely and effectively perform RFA for hyperthyroidism. 

RF Thyroid Ablation Technique

Radio frequency thyroid ablation is incredibly safe. However, as with any medical procedure, using the proper technique is crucial. Let’s discuss how to safely perform thyroid ablation with something called a moving shot technique:

  1. Using your handheld ultrasound probe, identify the location of the patient’s thyroid nodule that needs to be ablated. Ideally, use a needle guide attached to a probe that maintains the electrode probe on the same plane as your ultrasound imaging. This ensures full visibility of the thyroid and the electrode needle. 
  2. Before the moving shot technique, penetrate the patient’s skin, entering the thyroid nodule. 
  3. Then, begin ablating the peripheral portion of the nodule. Move the needle back after air bubbles occur. Repeat this process line by line, posterior to anterior. Then, check the next section for ablation using a longitudinal scan. Repeat the moving shot technique, ablating the superior portion of the nodule. 
  4. Repeat this moving shot technique from the lower pole plane to the upper pole plane to ablate the entire nodule. 

Note: Use slow, steady movements to avoid unwanted penetration or ablation of surrounding tissues or critical structures. 

Additional Considerations for Performing RFA Thyroid Therapy

  • Apply local anesthesia first. 
  • Provide ice for the patient to reduce pain and inflammation after the procedure.
  • Monitor the patient for 20-30 minutes after. 
  • Perform proper follow-up. After safely performing the procedure, the patient should experience significant thyroid nodule shrinkage over a period of 12-24 months. Schedule follow-up for 1 month, 3 months, 6 months, and 12 months at a minimum. Monitor shrinkage and mitigate potential complications.

You do not need to provide lifelong hormone supplementation to the patient. Hyperthyroidism is incredibly rare after undergoing RFA.

Avoiding Complications

While performing the procedure, prepare to take longer for larger thyroid nodules. Be aware of critical structures surrounding the thyroid gland. 

This includes the recurrent laryngeal nerve (RLN), trachea, internal jugular veins, and columnar arteries. If the patient’s nodule has extended into the chest, it may not be safe to perform RFA. 

You should also avoid RFA if the patient is a pacemaker or is pregnant. 

Qualifications To Perform Thyroid Ablation

Reduce the risk to the patient. Thyroid ablation should only be performed by qualified physicians, such as interventional radiologists, general surgeons, head surgeons, neck surgeons, and endocrinologists. 

Equipment for RF Thyroid Ablation

Here’s a list of equipment that is recommended to perform the procedure safely:

  • Doppler screen – the physician should be able to view the patient’s thyroid nodule at all times. 
  • Ultrasound probe – ideally, a handheld device will be used in which the physician guides the probe to be in line with the plane of the thyroid nodule. This enables vision of the entire shaft of the electrode. 
  • A needle guide on the ultrasound probe –  a needle guide enables the physician to have full vision of the entire shaft of the electrode probe for proper ablation, neither undertreating nor overablating surrounding tissues. This guide makes the moving shot technique much easier. 
  • Local anesthesia – local anesthesia should be administered before performing the operation. 
  • RF generator -the RF generator is what makes the thermal ablation possible. One quality RF generator is the Mygen V-1000. It comes pre-programmed with various algorithms depending on the thermal procedure. 
  • Grounding pad – grounding pads should be attached to each thigh of a patient to prevent electrical injuries. 
  • RF electrode – the RF electrode needle / probe serves two purposes. It penetrates the patient’s skin and the patient’s thyroid nodule, and it provides the end point of the radio frequency ablation. This kills the unwanted tissue.

Treat Thyroid Nodules Without Surgery

Want to learn more about thyroid radiofrequency ablation treatment? Contact RGS Healthcare today. Learn how to use the proper tools and techniques for safe patient outcomes.