ABSTRACT
BACKGROUND: The purpose of this study was to evaluate a novel bipolar radiofrequency ablation (BRFA) device using nanotechnology for division of all named vessels during thyroidectomy. METHODS: All thyroidectomies from January 2008 to July 2010 at a single institution used the BRFA device (EnSeal, Ethicon Endo-Surgery, Cincinnati, OH) for hemostasis. Clinicopathologic data and complications were recorded and compared with existing literature using other energy devices. RESULTS: Fifty-eight thyroidectomies were performed. Mean age was 54.7 years, and mean operating room time was 81 minutes. The average estimated blood loss was 46 mL. Ninety percent of patients were discharged in <23 hours. There were no hemorrhages. There was 1 recurrent laryngeal nerve (RLN) injury, and 1 case of transient hypocalcemia. CONCLUSION: This first small series using the BRFA device reveals initial safety and effectiveness for thyroid hemostasis, and warrants further study. The minimal thermal spread inherent in this device may make it an attractive option when structures such as the RLN may be near the zone of hemostasis.
Subject(s)
Catheter Ablation/instrumentation , Hemostasis, Surgical/instrumentation , Nanotechnology/instrumentation , Postoperative Hemorrhage/prevention & control , Thyroid Gland/surgery , Thyroidectomy/adverse effects , Adult , Aged , Catheter Ablation/adverse effects , Female , Hemostasis, Surgical/adverse effects , Humans , Laryngeal Nerve Injuries/diagnosis , Laryngeal Nerve Injuries/etiology , Male , Middle Aged , Nanotechnology/methodsABSTRACT
Spiral enteroscopy is the newest of the deep enteroscopy techniques. The current technique employs an overtube with a raised spiral at the distal end to pleat the small intestine and achieve deep small bowel intubation. Although spiral enteroscopy is a novel technique, the learning curve is comparable to the balloon enteroscopy techniques. There is some evidence of improved speed of spiral enteroscopy procedures with superior control compared to the balloon endoscopy technologies. Altered surgical anatomy deep enteroscopy has been shown to have similar safety and efficacy to competitive technologies, particularly in cases of Roux-en-Y ERCP cases. Spiral enterosopy is safe and effective for deep small bowel enteroscopy and diagnostic yield and therapeutic yields are similar to alternate technologies. There are bright future applications of the technology with enteroscopes and an integrated spiral. Spiral enteroscopy is an advanced technique that can be performed by any skilled endoscopist.
