Thermal Ablation as a Game Changer: It Will Replace 50% of Thyroid Surgeries, Dr. Giovanni Mauri

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Introduction ⦿ Host: Welcome by the host of the RFAMD podcast. ⦿ Guest: Introduction of Dr. Giovanni Mauri, a medical professional from Milan, Italy.

Dr. Mauri's Journey into Medicine ⦿ Childhood Influence: Inspired by his father, a radiologist. ⦿ Career Choice: Fascination with radiology and interventional radiology. ⦿ Family Background: His father worked in diagnostic radiology in an oncological hospital.

History of Ablation in Italy ⦿ Early Adoption: Discussion of pioneers in ablation treatments in Italy, starting in the 1980s. ⦿ Development: The evolution of ablation techniques, from ethanol ablation for liver cancers to radiofrequency ablation.

Dr. Mauri's Specialization ⦿ Scope of Ablation: Treating various cancers (liver, kidney, lung, bone, soft tissues) with thermal ablation. ⦿ Focus on Thyroid Ablation: Special emphasis on treating both benign and malignant thyroid diseases.

Patient Success Stories ⦿ Personal Case: A female patient treated multiple times for lymph node metastasis, avoiding further surgery. ⦿ Impact on Patients: Emphasizing the success and life-changing effects of successful thyroid ablation treatments.

Thyroid Surgery vs. Ablation ⦿ Patient Perspective: Benefits in terms of invasiveness and future hormonal treatment. ⦿ Medical Community: Surgeons appreciating the option of ablation to manage resources and time effectively.

Global Trends in Thyroid Ablation ⦿ FDA Approval: The significant impact of FDA approval in the U.S. in 2018. ⦿ Rapid Growth: Thyroid ablation as the fastest-growing field in ablation treatments worldwide.

Dangers of Rapid Growth ⦿ Training and Expertise: Emphasizing the necessity of proper training and the risks posed by inexperienced practitioners. ⦿ Comparison of Techniques: Differences between traditional surgery and ultrasound-guided ablation procedures.

Pioneers in Thyroid Ablation ⦿ Innovations: Introduction of specifically designed needles and techniques in Korea and Italy. ⦿ Global Adoption: The spread of thyroid ablation practices to countries like South America, North America, and Europe.

Risks of Thyroid Ablation ⦿ Medical Risks: Potential damages during the procedure, such as bleeding or nerve damage. ⦿ Technical Challenges: Importance of ultrasound skills and adjunctive techniques to minimize risks.

Post-Treatment Recovery ⦿ Patient Experience: Comparing recovery to dental work, with minimal pain and quick return to normal life. ⦿ Potential Complications: Rare cases of hematoma, mainly aesthetic concerns.

Unsuccessful Cases ⦿ Benign Nodules: Rare unsuccessful cases, often due to initial under-treatment. ⦿ Malignant Tumors: Possibility of incomplete ablation, with options for re-treatment.

Selecting the Right Provider ⦿ Criteria for Choosing: Experience of the physician, ideally in a hospital setting for beginners. ⦿ Importance of Supervision: Emphasis on proper environment and supervision for new practitioners.

Addressing Skepticism ⦿ Literature and Communication: Using scientific evidence and open discussions to address concerns. ⦿ Surgical Alternatives: Emphasizing ablation as a reversible option compared to definitive surgery.

Types of Ablation ⦿ Radiofrequency vs. Microwave: Discussion on the advantages and risks of each type in thyroid treatments.

Guidelines and Clinical Experience ⦿ Lag in Guidelines: The delay in incorporating new treatments like ablation into official guidelines. ⦿ Individualized Treatment: Tailoring treatment options based on clinical experience, despite guidelines.

Patient Counseling ⦿ Approach to Counseling: The importance of discussing all treatment options with patients. ⦿ Team Collaboration: Multidisciplinary approach in decision-making and patient communication.

Patient Perception and Decision Making ⦿ Overdiagnosis and Overtreatment: Addressing the issue of overdiagnosis in thyroid cancer and the role of minimally invasive treatments. ⦿ Patient Preferences: Understanding patient choices in treatment options, including active surveillance.

Second Opinions and Treatment Choices ⦿ Changing Treatment Plans: Cases where patients change their mind after seeking a second opinion. ⦿ Informed Decision Making: The importance of providing comprehensive information to patients.

Innovations in Thyroid Treatment ⦿ New Technologies: Exploring new treatments like embolization, expanding the scope of minimally invasive procedures.

Conclusion and Rapid Fire Questions ⦿ Future of Thyroid Treatment: Predictions about the shift towards ablation in the next decade. ⦿ Importance of Communication: The crucial role of clear communication in discussing cancer treatments with patients.

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