Radiofrequency ablation therapy for thyroid nodules – instead of surgery
Thyroid is a gland that is located in the neck and secretes a hormone that is essential for the body metabolism.
Thyroid nodules are common in the population. Most nodules are benign (non-cancerous), but sometimes they need to be removed as they cause symptoms such as a prominent "lump" in the neck or swallowing or breathing disorders. So far this has required general anesthesia to remove all or part of the thyroid gland.
What are the symptoms? There may be a feeling of difficulty swallowing, discomfort in breathing, and most often – aesthetic disorder due to the appearance of a prominent "lump" in the neck.
How to diagnose? In the first stage, an ultrasound of the neck, a puncture (needle biopsy) and laboratory tests should be performed to assess glandular function. Once we have verified that we deal with a relevant nodule and that it is benign, it is possible to shrink the nodule by using radiofrequency ablation (RFA), thus avoiding surgery under general anesthesia.
How is RFA therapy for thyroid nodules performed? The ablation is performed only under regional anesthesia (for the neck). During the procedure with an ultrasound scan, a puncture is performed with a needle transmitting radio waves, which are transformed into heat inside the tissue. As a result, the destruction of nodule tissue occurs, which leads to its shrinking. The duration of the treatment is approximately 20 minutes. A single treatment is usually sufficient.
Results of treatment? According to studies conducted around the world, treatment results in 50% to 70% reduction, and the disappearance of the symptoms. The reduction of nodules takes place within a few weeks, the record being a 5-month period. The results remain for many years.
Complications – It is important to note that complications are rare! These are mostly minor complications: neck swelling, skin bleeding, transient discomfort. Significant complications – damage to the recurrent laryngeal nerve and skull nerves – have been described in only a few cases worldwide. Rupture of the nodule. Excessive activity of the gland.
Thyroid and parathyroid glands surgery with no scar on the neck
The thyroid gland: Approximately 1000 new cases of thyroid cancer are diagnosed in Israel each year. Common and primary treatment is surgery in which some or all of the gland is removed. In this operation the approach is through an incision at the base of the neck, which leaves a scar on the neck.
The parathyroid gland – These are four tiny glands responsible for the body’s calcium levels. These glands are in close proximity to the thyroid gland. Sometimes one of the glands functions independently and disrupts the calcium level – a "parathyroid adenoma".
Because of this, surgery is sometimes required to remove the adenoma, and it is also performed through a neck incision, which leaves a scar.
How is scar-free surgery to remove the thyroid or parathyroid gland performed?
This is an innovative surgical procedure that has been carried out at several centers around the world in recent years – and for about a year it has been performed in Israel. The surgery is performed using the endoscopic approach – through the oral cavity to the neck. The camera and the tools are inserted through 3 tiny incisions in the lower lip mucous membrane, so no visible scar remains on the skin. From this moment on, the course of the operation is the same as in an open surgery in both stages and complications. The additional benefit of surgery using this approach is the ability to view the procedure on the screen in high resolution and magnification (4K), which allows achieving maximum accuracy.
What are the benefits? After the recovery from an operation – you can forget that you have had surgery – due to the absence of any visible scar on the neck or skin!
What is the recovery process from surgery? The recovery is similar to that, which follows a neck surgery only without dealing with the scar or drainage. In the first days there are swelling of the lower lip and dietary restrictions. Continuation of the healing process at home is the same as recovery after an open surgery.
Complications? Similar to the thyroid surgery, the major complications are damage to the recurrent laryngeal nerve, bleeding, the above-mentioned rare complications. In addition, transient or permanent submental sensory disorder (rare), cutaneous burn, carbon dioxide embolism (rare) may occur.
Who is this operation suitable for? The operation is suitable for the treatment of some thyroid malignant tumors, benign tumors, and parathyroid adenomas.
