How should I prepare for Ablation and what should I expect during the procedure?
To prepare for the procedure, you will need to wear a comfortable open necked dark coloured top and shorts or a skirt. You will need to remove long pants and neck coverings, jewelry, glasses, and removable dental appliances.
You will be fully awake during the procedure. However, some patients may choose to take medicine to help them relax – this can be discussed with Dr Sinclair in the pre-operative consultation.
You will lie down comfortably on the procedure table with your neck extended slightly. Before the procedure, your thyroid is examined with the ultrasound to locate and measure the dimensions of your thyroid nodule.
Two grounding pads will be placed on your thighs. Your neck will then be cleaned and disinfected to avoid infection.
The thyroid capsule has sensory nerves that can feel pain. Local anesthesia is injected into the skin with a thin needle and into the capsule of the thyroid gland. You may feel a prick and burn when the local anesthesia is injected. However, there is usually not a significant amount of pain with this procedure.
Under ultrasound guidance, the RFA electrode is then inserted and positioned into the target nodule. The RFA system is activated. Dr Sinclair will perform the procedure by moving the electrode throughout the nodule and monitoring the status of the ablation using real-time ultrasound imaging.
During the procedure, the Dr Sinclair may ask you to speak to ensure that you are comfortable and to detect any voice changess. Some patients may hear a popping sound which is common and normal. Ear, jaw, shoulder and neck discomfort can also occur and you should let Dr Sinclair know if you are uncomfortable at any time.
Once the nodule is treated completely, Dr Sinclair will perform a final ultrasound scan to ensure the nodule has been fully ablated to the best of her ability. Once satisfied, the electrode and grounding pads will be removed, the insertion site will be cleaned, and a small bandage will be applied.
You will then be seated in the waiting room and observed for between 20-30 minutes. Dr Sinclair will then examine your neck to check for any swelling and to go over any final questions. You are then able to go home and continue your normal activities the next day with the exception of heavy lifting and heavy exercise (these should be avoided for one week after the procedure). It is recommended to apply an ice pack to help with any swelling and to take pain medication if needed.
You will have follow up ultrasound scans at 6-8 weeks, 6 months and 12 months post procedure to check the nodule volume reduction and overall success of the Thyroid RFA procedure. A/Prof Sinclair will either do these scans personally for people who live in Melbourne or Sydney or give you appropriate ultrasound request forms for people who live in other States.