Thermal Ablation

Thermal ablation, as the name suggests, is a procedure based on developing heat to cause necrosis, the death of the cells of the treated nodule or lesion. However, the word “ablation” carries within itself a contradiction that is worth explaining: in fact there isn’t an actual ablation, there is no surgical removal of the nodule, but the thermal effect caused by the energy channeled by the device into the tissue causes the death of the cells exclusively into the chosen area. Consequently the treated nodule, basically burned by heat, undergoes a scarring process, it’s digested by our histiocytic and macrophagic system (cleanup cells that remove necrotic debris), and as a result, it reduces up to 60% of its initial volume from one to six months, reaching 80-90% in a period that goes from 1 to 2 years.
The main techniques used in clinical practice are Laser, Radiofrequency, and Microwave: all involve the introduction of a device (needle-like) that is inserted, after local anesthesia and under ultrasound guidance, into the nodule that causes compression in the neck or an evident aesthetic deformity (goiter) that distorts its physiological image.
At the end of the treatment, which typically lasts between five and thirty minutes depending on the volume to be treated and the amount of energy used, the patient is discharged after being observed for one to two hours for necessary checks, being able to return immediately to their work and social life. Check-ups usually have a frequency of one, three, six months, twelve months, and then annually. These are useful, in the first year, to define the volumetric reduction curve and the effectiveness of the treatment, also evaluating thyroid function; later, they monitor the course over the years. Only a small percentage of treated patients may experience partial regrowth of tissue around the treated or incompletely treated area, but in the follow-ups available in scientific literature, only a minimal portion of nodules develop significant regrowth.