Energy-based devices in thyroid surgery—an overview

Bakkar, Sohail; Papavramidis, Theodossis S; Aljarrah, Qusai; Materazzi, Gabriele; Miccoli, Paolo

doi:10.21037/gs.2019.08.05

Cited by 25 publications

(30 citation statements)

References 20 publications

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“…Recently, ultrasonic, ABP and hybrid devices have been characterized as advanced energy devices in cross-specialty literature, given similarities in their various purposes, including hemostasis, sealing, transection and dissection of blood vessels, as well as technological advancements [15][16][17] . For the purpose of this work, we define advanced energy devices as electrosurgical devices that leverage recent advancements on conventional monopolar and bipolar electrosurgical instruments, such as increased compression, integrated cutting blade in ABPs, and algorithmic energy control, to achieve coagulation and transection involved in surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

A device category economic model of electrosurgery technologies across procedure types: a U.S. hospital budget impact analysis

Ferko

Wright

Syed

et al. 2021

Journal of Medical Economics

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Aims:The electrosurgical technology category is used widely, with a diverse spectrum of devices designed for different surgical needs. Historically, hospitals are supplied with electrosurgical devices from several manufacturers, and those devices are often evaluated separately; it may be more efficient to evaluate the category holistically. This study assessed the health economic impact of adopting an electrosurgical device-category from a single manufacturer. Methods: A budget impact model was developed from a U.S. hospital perspective. The uptake of electrosurgical devices from EES (Ethicon Electrosurgery), including ultrasonic, advanced bipolar, smoke evacuators, and reusable dispersive electrodes were compared with similar MED (Medical Energy Devices) from multiple manufacturers. It was assumed that an average hospital performed 10,000 annual procedures 80% of which involved electrosurgery. Current utilization assumed 100% MED use, including advanced energy, conventional smoke mitigation options (e.g. ventilation, masks), and single-use disposable dispersive electrode devices. Future utilization assumed 100% EES use, including advanced energy devices, smoke evacuators (i.e. 80% uptake), and reusable dispersive electrodes. Surgical specialties included colorectal, bariatric, gynecology, thoracic and general surgery. Systematic reviews, network meta-analyses, and meta-regressions informed operating room (OR) time, hospital stay, and transfusion model inputs. Costs were assigned to model parameters, and price parity was assumed for advanced energy devices. The costs of disposables for dispersive electrodes and smokeevacuators were included. Results: The base-case analysis, which assessed the adoption of EES instead of MED for an average U.S. hospital predicted an annual savings of $824,760 ($101 per procedure). Savings were attributable to associated reductions with EES in OR time, days of hospital stay, and volume of disposable electrodes. Sensitivity analyses were consistent with these base-case findings. Conclusions: Category-wide adoption of electrosurgical devices from a single manufacturer demonstrated economic advantages compared with disaggregated product uptake. Future research should focus on informing comparisons of innovative electrosurgical devices.

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Section: Introductionmentioning

confidence: 99%

A device category economic model of electrosurgery technologies across procedure types: a U.S. hospital budget impact analysis

Ferko

Wright

Syed

et al. 2021

Journal of Medical Economics

View full text Add to dashboard Cite

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“…Use of EBDs in thyroid surgery has increased because EBDs increase hemostasis efficiency, decrease operation time, and prevent life-threatening hematoma. [1][2][3] Some studies indicate that, compared to conventional clamp-and-tie technique, EBDs obtain superior outcomes in thyroid surgery, including pain, hospital stay, blood loss, postoperative drainage, and incidence of postoperative hypocalcemia. [4][5][6][7] However, the high temperatures, lateral thermal spread, and the residual heat generated by EBDs can cause unexpected iatrogenic thermal injury to recurrent laryngeal nerves (RLNs).…”

Section: Introductionmentioning

confidence: 99%

“…Each method has inherent advantages and disadvantages resulting from their different mechanisms. 1,3 Ferromagnetic (FM) technology is a new surgical EBD that could be effective for hemostasis and dissection during thyroid surgery. This device generates high-frequency alternating current and transmits it through the heating elements of the device to create a rapidly alternating magnetic field.…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, research and development of energy‐based devices (EBD) have played an important role in improving the overall quality of thyroid surgery. Use of EBDs in thyroid surgery has increased because EBDs increase hemostasis efficiency, decrease operation time, and prevent life‐threatening hematoma 1‐3 . Some studies indicate that, compared to conventional clamp‐and‐tie technique, EBDs obtain superior outcomes in thyroid surgery, including pain, hospital stay, blood loss, postoperative drainage, and incidence of postoperative hypocalcemia 4‐7 .…”

Section: Introductionmentioning

confidence: 99%

“…Currently, the EBDs most commonly used in thyroid surgery are based on bipolar (Ligasure) and ultrasonic (Harmonic) technology. Each method has inherent advantages and disadvantages resulting from their different mechanisms 1,3 …”

Section: Introductionmentioning

confidence: 99%

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Safety parameters of ferromagnetic device during thyroid surgery: Porcine model using continuous neuromonitoring

et al. 2020

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Background The ferromagnetic (FM) device is a new surgical energy modality. This study investigated dynamic recurrent laryngeal nerve (RLN) electromyographic (EMG) data to define safety parameters for using FM devices in thyroidectomy. Methods Real‐time EMG tracings obtained under continuous neuromonitoring were recorded from 24 RLNs (12 piglets). In the activation study, FM devices were activated at varying distances from the RLN. In the cooling study, FM devices were cooled for varying time intervals, or muscle touch maneuver was performed, before contact with the RLN. Results During the FMwand/FMsealer activation, no adverse EMG events occurred at distances of 2 mm or longer. The cooling study revealed no adverse EMG events after 1‐second (FMwand) or 3‐second (FMsealer) intervals or after muscle touch maneuver. Conclusions An FM device should be activated at a distance of 2 mm from the RLN and should be adequately cooled before further contact with the RLN. Surgeons can avoid RLN injury by observing standard procedures for using FM devices.

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Energy-based devices in thyroid surgery—an overview

Cited by 25 publications

References 20 publications

A device category economic model of electrosurgery technologies across procedure types: a U.S. hospital budget impact analysis

A device category economic model of electrosurgery technologies across procedure types: a U.S. hospital budget impact analysis

Safety parameters of ferromagnetic device during thyroid surgery: Porcine model using continuous neuromonitoring

Moderne Schilddrüsenchirurgie

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