Summary: The Moving Shot Technique in thyroid radiofrequency ablation (RFA) ensures effective nodule treatment while protecting surrounding structures. This technique systematically ablates nodules unit by unit, enhancing safety, precision, and cosmetic outcomes.
- Minimizes Damage: Targets small ablation units to protect the esophagus, trachea, and nerves.
- Enhances Safety: Reduces risks of burns and unintentional structural damage.
- Increases Effectiveness: Achieves an average VRR of 84.5% and improves cosmetic outcomes.
- Minimally Invasive: Quick recovery with no complications or regrowth observed in studies.
- Training Opportunities: STARmed America offers comprehensive training programs to master the technique.
One of the key benefits of radiofrequency ablation (RFA) for the thyroid is the procedure’s ability to ablate benign nodules without damage to surrounding structures.
You might compare it to a procedure such as Microwave Ablation (MWA), which has larger ablative margins, often leading to carbonization and lower long-term VRR. RFA’s smaller, thinner electrodes produce considerably more predictable zones of ablation. Likewise, the lower temperatures used in RFA decrease the chances of burns and other unintentional structural damage.
Additionally, thyroid ablation techniques, such as the moving shot technique, can ensure the most complete ablation of nodules during the procedure. In this blog, we’ll share more about the moving shot technique for the thyroid, including how clinicians can pursue further training to master the ablation technique and apply it in practice.
What Is the Moving Shot Technique in Radiofrequency Ablation?
The thyroid is a small, delicate gland surrounded by many critical structures, including:
- The esophagus
- The trachea
- The recurrent laryngeal nerve
- The carotid artery
- The vagus nerve
- The cervical sympathetic ganglion
Thus, preventative RFA techniques, such as the moving shot technique, are crucial for ensuring a patient’s quality of life post-procedure.
In essence, the moving shot technique approaches RFA by breaking the thyroid down into multiple small ablation units. Each unit is then treated individually, limiting damage to nearby structures.
When the tip of the electrode stays in one area during the ablation, there is a gradual increase in the ablation zone. However, ablation is safest when the electrode is positioned 1-2 mm away from the margin of the nodule. Thus, during the moving shot technique, clinicians ablate the nodule unit by unit for seconds per unit. It’s a safe and efficacious approach to treating the neck and throat with minimal complications.
During the ablation, clinicians begin by positioning the RFA electrode in the deepest, most remote portion of the nodule. Subsequently, the clinician retracts the electrode to the most superficial portion of the nodule. This prevents the limitation of the acoustic window due to air bubbles and ensures that every area of the nodule is covered.
During the moving shot technique, ablation is always suspended when moving the electrode in a forward direction. This further reduces the incidence of structural damage.
Visualizing the Moving Shot Technique for Thyroid
It can be helpful for clinicians new to the moving shot technique to imagine it like painting on a canvas. Imagine you are painting something precise, like a thin, straight line. If you hold the paint-saturated brush in one place, the paint will build up unevenly. Rather than a straight line, you’ll have an area of uneven thickness.
However, when utilizing the moving shot technique, clinicians move the “paintbrush” (electrode) in a controlled, deliberate, sweeping motion. This creates a smooth, even stroke, so no one spot is painted (or heated) excessively.
By systematically moving through the targeted area during RFA, the clinician ensures thorough ablation while avoiding excessive heating in any one location. Additionally, real-time ultrasound guidance helps verify the coverage area and effectiveness of the ablation.
Benefits of the Moving Shot Ablation Technique
The moving shot radiofrequency ablation technique maximizes effectiveness while protecting healthy tissue. Based on a clinical study published in Medicina, specific benefits of using this technique in practice include:
- Significant volume reduction. In clinical trials, patients experienced a substantial decrease in tumor size, achieving an average volume reduction ratio (VRR) of 84.5 ± 9.2%.
- Cosmetic improvement. In the same study, the cosmetic scale (CS) scores improved markedly. They decreased from an average of 3.71 to 1.57 post-procedure, indicating enhanced aesthetic outcomes.
- Safety profile. No complications or regrowth of targeted lesions were observed during the study’s follow-up period, underscoring the procedure’s safety.
- Minimally invasive with quick recovery. The procedure is minimally invasive, often performed under local anesthesia. This allows for swift recovery and minimal downtime.
These findings suggest that the moving shot technique in RFA is an effective and safe treatment modality for benign soft tissue neoplasms. The technique offers significant clinical and cosmetic benefits for doctors and patients alike.
Improving Patient Outcomes Through Clinical Training
According to recent studies, radiofrequency ablation is particularly friendly to new physicians. It allows them to quickly master the procedure and achieve precise control in as few as 20 procedures.
Another study on the RFA learning curve noted significant improvements in technique efficacy, volume reduction rate (VRR), and ablation rate (AR) after the initial 30 cases.
Thus, even less proficient practitioners can achieve stable treatment efficacy in a fairly short period of time. New clinicians can achieve even better outcomes by pursuing further training in the moving shot technique.
We advise those interested in further education to seek out live practice opportunities in training labs, workshops, and real-world clinical settings.
Transform your Practice with STARmed
STARmed America offers comprehensive training programs designed to equip physicians with the skills necessary to perform the moving shot technique. Our programs combine theoretical knowledge with practical experience to ensure proficiency in the procedure.
Beyond formal training, STARmed America provides ongoing support through our STAR Support program. We offer clinicians clinical case assistance, reimbursement guidance, and marketing support to help integrate RFA procedures into clinical practice effectively.
For more information on upcoming training sessions and resources, visit the STARmed Academy website.
