Comparing the safety of harmonic ACE and ACE plus around the recurrent laryngeal nerve in swine models
- Authors
- Kim, Hong Kyu; Chai, Young Jun; Lee, Hye Yoon; Kim, Hoon Yub; Dionigi, Gianlorenzo
- Issue Date
- 6월-2018
- Publisher
- KOREAN SURGICAL SOCIETY
- Keywords
- Thyroid; Recurrent laryngeal nerve; Neuromonitoring
- Citation
- ANNALS OF SURGICAL TREATMENT AND RESEARCH, v.94, no.6, pp.285 - 290
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- ANNALS OF SURGICAL TREATMENT AND RESEARCH
- Volume
- 94
- Number
- 6
- Start Page
- 285
- End Page
- 290
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/75439
- DOI
- 10.4174/astr.2018.94.6.285
- ISSN
- 2288-6575
- 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.
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