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 language | English |
|---|---|
| Pages (from-to) | 285-290 |
| Number of pages | 6 |
| Journal | Annals of Surgical Treatment and Research |
| Volume | 94 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2018 Jun 1 |
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Keywords
- Neuromonitoring
- Recurrent laryngeal nerve
- Thyroid
ASJC Scopus subject areas
- Surgery
Cite this
Comparing the safety of harmonic ACE and ACE+ around the recurrent laryngeal nerve in swine models. / Kim, Hong Kyu; Chai, Young Jun; Lee, Hye Yoon; Kim, Hoon Yub; Dionigi, Gianlorenzo.
In: Annals of Surgical Treatment and Research, Vol. 94, No. 6, 01.06.2018, p. 285-290.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Comparing the safety of harmonic ACE and ACE+ around the recurrent laryngeal nerve in swine models
AU - Kim, Hong Kyu
AU - Chai, Young Jun
AU - Lee, Hye Yoon
AU - Kim, Hoon Yub
AU - Dionigi, Gianlorenzo
PY - 2018/6/1
Y1 - 2018/6/1
N2 - 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.
AB - 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.
KW - Neuromonitoring
KW - Recurrent laryngeal nerve
KW - Thyroid
UR - http://www.scopus.com/inward/record.url?scp=85048522484&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048522484&partnerID=8YFLogxK
U2 - 10.4174/astr.2018.94.6.285
DO - 10.4174/astr.2018.94.6.285
M3 - Article
AN - SCOPUS:85048522484
VL - 94
SP - 285
EP - 290
JO - Annals of Surgical Treatment and Research
JF - Annals of Surgical Treatment and Research
SN - 2288-6575
IS - 6
ER -