Comparing the safety of harmonic ACE and ACE+ around the recurrent laryngeal nerve in swine models

Hong Kyu Kim, Young Jun Chai, Hye Yoon Lee, Hoon Yub Kim, Gianlorenzo Dionigi

    Research output: Contribution to journalArticlepeer-review

    4 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)285-290
    Number of pages6
    JournalAnnals of Surgical Treatment and Research
    Volume94
    Issue number6
    DOIs
    Publication statusPublished - 2018 Jun

    Keywords

    • Neuromonitoring
    • Recurrent laryngeal nerve
    • Thyroid

    ASJC Scopus subject areas

    • Surgery

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