Lateral spread of heat during thyroidectomy using different haemostatic devices
Zbigniew Adamczewski1, Aleksander Król2, Karolina Kałużna-Markowska3
11. Department of Endocrinology and Metabolic Diseases, Medical University, Łódź, Poland 2. Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital/Research Institute, Łódź, Poland.
Annals of Agricultural and Environmental Medicine : AAEM
|September 26, 2015
Summary
This study analyzed heat spread during thyroidectomy using thermal imaging. A minimal safety margin of 5.51 mm is proposed for hemostatic devices to ensure recurrent laryngeal nerve safety.
Area of Science:
- Surgical Technology
- Thermodynamics in Medicine
- Neurosurgery
Background:
- Thyroidectomy involves thermal risks, necessitating analysis of heat spread.
- Understanding lateral heat spread is crucial for surgical safety and may apply to other disciplines.
Purpose of the Study:
- To evaluate temperature distribution during thyroidectomy with modern hemostatic instruments.
- To define a safety margin for devices used in thyroid surgery.
Main Methods:
- Thermovisual measurements and continuous intraoperative neuromonitoring (CIONM) were performed on 93 patients undergoing thyroidectomy.
- Patients were grouped by hemostatic device: LigaSure, ThermoStapler, Focus, SonoSurg, and Monopolar.
Main Results:
- ThermoStapler showed the highest working temperature, Monopolar the lowest.
- Focus and SonoSurg had increased safety margins and working times compared to LigaSure and ThermoStapler.
- A minimal safety margin of 5.51 mm from the 42°C isotherm was identified, with no CIONM signal changes beyond this distance.
Conclusions:
- Thermo-visual cameras offer safe, real-time, non-invasive monitoring of intraoperative temperature.
- A recommended minimal safety margin of 5.51 mm is established for the analyzed hemostatic devices during thyroidectomy.
