Safety of Ligasure exact dissector in thyroidectomy with continuous neuromonitoring: A porcine model

Tzu Yen Huang, Yi Chu Lin, Hsin Yi Tseng, Gianlorenzo Dionigi, Hoon Yub Kim, I. Cheng Lu, Pi Ying Chang, Feng Yu Chiang, Che Wei Wu

    Research output: Contribution to journalArticlepeer-review

    8 Citations (Scopus)


    Background: The purpose of this study was to investigate and define safety parameters for using the Ligasure exact dissector (LED) for dissection close to the recurrent laryngeal nerve (RLN) during thyroidectomy. Methods: Real-time electrophysiologic electromyographic (EMG) tracings were recorded in 16 RLNs (8 piglets) during various applications of LED under continuous intraoperative monitoring in this prospective porcine model study. In the activation study, LED was activated at varying distances from the RLN. In the cooling study, LED was activated with different cooling times or after touching the sternocleidomastoid muscle before application to the RLN. Results: In the activation study, no adverse EMG events occurred at distances longer than 1 mm. In the cooling study, no adverse EMG events occurred after a 2-second cooling time. Additionally, no adverse EMG events occurred when a sternocleidomastoid muscle touch maneuver was used for cooling. Conclusions: The LED can be safely used at distance of 1 mm or longer, and it should be cooled for at least 2 seconds or by muscle touch maneuver. Thyroid surgeons can avoid RLN injury if standard procedures for LED use are observed.

    Original languageEnglish
    Pages (from-to)702-710
    Number of pages9
    JournalGland Surgery
    Issue number3
    Publication statusPublished - 2020


    • Continuous neuromonitoring
    • Ligasure exact dissector (LED)
    • Nerve thermal injury
    • Recurrent laryngeal nerve (RLN)
    • Thyroid surgery

    ASJC Scopus subject areas

    • Surgery


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