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Updated: Feb 8, 2026

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
Thermal effects of the Thunderbeat™ device on the recurrent laryngeal nerve during thyroid surgery
Atsumi Tamura1, Hidemitsu Tsutsui2, Yukiko Yano2
1Department of Chest and Thyroid Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. atsumi0107@gmail.com.
Purpose:
To investigate the safety of the Thunderbeat™ (TB) device in thyroid surgery by clarifying its thermal effects on the recurrent laryngeal nerve (RLN).
Methods:
We performed thyroidectomy using TB on four female pigs under general anesthesia. TB was applied 0, 1, and 2 mm from the RLN. The effects of incisions made in tissues in the vicinity of the RLN were evaluated by intraoperative neuromonitoring and pathological examination.
Results:
The value of the neural integrity monitor (NIM) was unchanged at 2 and 1 mm, but there was loss of signal at 0 mm. The differences between 2 and 0 mm were not clear from the pathological findings.
Conclusions:
When using the TB device during thyroid surgery, it is recommended that it is visually kept from making any contact with the RLN.
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