Safety of LigaSure in recurrent laryngeal nerve dissection‐porcine model using continuous monitoring

Dionigi, Gianlorenzo; Chiang, Feng‐Yu; Kim, Hoon Yub; Randolph, Gregory W.; Mangano, Alberto; Chang, Po-Chun; Lu, I‐Cheng; Lin, Yi‐Chu; Chen, Hui‐Chun; Wu, Che‐Wei

doi:10.1002/lary.26271

Cited by 27 publications

(37 citation statements)

References 26 publications

(42 reference statements)

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“…Animal models have accelerated research and development of IONM. In the past decade, new applications of IONM in thyroid surgery have been described in animal studies, most of which have used medium-sized experimental animals such as canine/dog (15)(16)(17) and porcine/swine/mini-pig (13,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37).…”

Section: Animal Models For Ionm Researchmentioning

confidence: 99%

Intraoperative neural monitoring in thyroid surgery: lessons learned from animal studies

Randolph

et al. 2016

Gland Surg.

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Recurrent laryngeal nerve (RLN) injury remains a significant morbidity associated with thyroid and parathyroid surgery. In the past decade, surgeons have increasingly used intraoperative neural monitoring (IONM) as an adjunct technique for localizing and identifying the RLN, detecting RLN injury, and predicting the outcome of vocal cord function. In recent years, many animal studies have investigated common pitfalls and new applications of IONM. For example, the use of IONM technology in animal models has proven valuable in studies of the electrophysiology of RLN injury. The advent of animal studies has substantially improved understanding of IONM technology. Lessons learned from animal studies have immediate clinical applications in establishing reliable strategies for preventing intraoperative RLN injury. This article gives an overview of the research progress on IONM-relevant animal models.

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Section: Animal Models For Ionm Researchmentioning

confidence: 99%

Intraoperative neural monitoring in thyroid surgery: lessons learned from animal studies

Randolph

et al. 2016

Gland Surg.

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“…The risk of collateral tissue damage has been a concern when used in tight spaces or in spaces where delicate structures are in close approximation to the structure being ligated (eg, the proximal portion of the optic nerve) . A study evaluating the safety of the recurrent laryngeal nerve when using the LigaSure™ during thyroidectomies showed that a distance of 2 mm from the nerve is safe for the activation of the LigaSure™ device . Despite the relative safety, the LigaSure™ can be positioned closely to the globe during ligation to ensure that injury to the proximal optic nerve does not occur, and histological interpretation of the optic nerve head will not be affected because of minimal risk for collateral damage by the LigaSure™.…”

Section: Discussionmentioning

confidence: 97%

“…22 A study evaluating the safety of the recurrent laryngeal nerve when using the LigaSure™ during thyroidectomies showed that a distance of 2 mm from the nerve is safe for the activation of the LigaSure™ device. 23 Despite the relative safety, the LigaSure™ can be positioned closely to the globe during ligation to ensure that injury to the proximal optic nerve does not occur, and histological interpretation of the optic nerve head will not be affected because of minimal risk for collateral damage by the LigaSure™. Overall, no adverse effects were encountered by use of the LigaSure™.…”

Section: Discussionmentioning

confidence: 99%

A novel surgical technique for enucleation in rabbits to reduce the risk of intra‐ and post‐operative orbital hemorrhage

Moore

Robertson

Tarbert

et al. 2020

Veterinary Ophthalmology

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A 10‐year‐old male castrated Holland Lop rabbit (Oryctolagus cuniculus) was presented for severe ulcerative stromal keratitis of the right eye and a luxated hypermature cataract and glaucoma of the left eye. Staged bilateral enucleation was elected. A LigaSure™ electrosurgical bipolar vessel‐sealing device was used as a means to minimize intraoperative and post‐operative hemorrhage, especially that associated with the orbital venous plexus. The LigaSure™ was used to ligate and transect all extraocular muscles, the optic nerve bundle, and the base of the third eyelid with no complications encountered. Overall, the LigaSure™ was easy to use, resulted in minimal hemorrhage, and reduced surgery time. This is the first report of the use of a LigaSure™ to aid in the enucleation of a rabbit. Although only positive results were achieved as an alternative to conventional methodologies, its use in clinical practice should be that of caution until a larger study evaluating the long‐term results is performed.

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“…PG autotransplantation not only increases the PH rate but may also cause permanent PH. 25,26 For example, three thermal injuries to the RLN in group L resulted from lateral thermal spread from LigaSure. 14 In this study, the preferred surgical strategy for preserving PG function was in situ preservation.…”

Section: Discussionmentioning

confidence: 99%

“…24 When using an EBD near the RLN, thyroid surgeons must carefully consider the potential risk of RLN injury from lateral thermal spread. 25,26 For example, three thermal injuries to the RLN in group L resulted from lateral thermal spread from LigaSure. Complete loss of EMG signal was found in two of three thermal injuries and resulted in permanent vocal cord palsy.…”

Section: Discussionmentioning

confidence: 99%

Comparison of hypocalcemia rates between LigaSure and clamp‐and‐tie hemostatic technique in total thyroidectomies

et al. 2019

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Background Postoperative hypocalcemia (PH) is a serious complication after total thyroidectomy. This study aimed to compare PH rates between LigaSure Small Jaw (LSJ) and clamp‐and‐tie hemostatic technique in patients undergoing total thyroidectomy. Methods Four hundred twenty patients were divided into two groups: group L (210 patients) performed with LSJ and group C (210 patients) with clamp‐and‐tie technique. Serum ionized calcium (iCa) was measured before and 12, 24, 48, 72 hours after surgery. PH was defined as iCa lower than 4.2 mg/dL in at least two measurements. Results There was no significant difference between groups in sex, age, extent of surgery, pathology, and the strategy of intraoperative management of parathyroid glands (PG). The PH rate was significantly lower in group L compared to group C (22.9% vs 32.4%, P = .03). Conclusions Compared to clamp‐and‐tie technique, LigaSure is superior to decrease PH rate after total thyroidectomy.

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Safety of LigaSure in recurrent laryngeal nerve dissection‐porcine model using continuous monitoring

Abstract: N/A. Laryngoscope, 127:1724-1729, 2017.

Cited by 27 publications

References 26 publications

Intraoperative neural monitoring in thyroid surgery: lessons learned from animal studies

Intraoperative neural monitoring in thyroid surgery: lessons learned from animal studies

A novel surgical technique for enucleation in rabbits to reduce the risk of intra‐ and post‐operative orbital hemorrhage

Comparison of hypocalcemia rates between LigaSure and clamp‐and‐tie hemostatic technique in total thyroidectomies

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