SantiagoHEMA
Specialized Hospital for Advanced Medicine: labs, cardiology and the procedure in the same building, fifteen minutes from the airport. The most practical choice if you fly in.
Radiofrequency ablation
A fine electrode, guided by ultrasound, applies heat inside the benign nodule, and the body gradually reabsorbs it. It is performed under local anesthesia, without an incision and with the gland in place. It does not suit every nodule, and that is assessed at the evaluation, before anything begins.
What it is
The heat is applied at one very precise point, and only there.
Radiofrequency is energy that, concentrated at the tip of an electrode as thin as a needle, produces heat. That heat, applied in parts inside the nodule, destroys its tissue; the body reabsorbs it over the following months and the nodule shrinks.
Everything happens under real-time ultrasound: the electrode is on screen at every moment, and so is everything around it. Entry is through the center of the neck, working from the inside out, to stay away from the nerves of the voice.
One session is almost always enough. In large nodules or nodules in both lobes a second one may be needed, and we let you know before we begin.
What to expect
What to expect, with numbers.
They come from published clinical studies, and the reference appears next to each figure.
- 70 %median volume reduction at twelve months. Almost eight in ten nodules shrink by half or more.Russell JO et al., Surgery 2024 (620 nodules); Korean Society of Thyroid Radiology, 2017 guideline.
- 10 to 23 %of nodules regrow in long-term follow-up, and about 12 % need a second treatment.Bernardi S et al., Frontiers in Endocrinology 2020 · Shin JH et al., Korean Journal of Radiology 2025.
- Almost alwaysthe gland keeps producing its hormone and there is no need to take it.Baek JH et al., Radiology 2012 (1,459 patients, 13 centers): permanent hypothyroidism in 0.07 % after radiofrequency ablation.
Symptom relief, pressure, discomfort when swallowing, the visible nodule, comes before the final figure. That is why ultrasound follow-up is part of the treatment. If yours regrows, we explain the options, a second session or, in some cases, surgery, and it is written in the evaluation.
Radiofrequency ablation
Your nodule may be treated without surgery.
Radiofrequency ablation shrinks the nodule from the inside, under local anesthesia, with no scar and same-day discharge. The videos are in Spanish.
Is it safe?
What about the voice?
It is the most asked question, and it makes sense: the nerve that moves the vocal cords passes right behind the thyroid.
In published series of benign nodules, a little over two in a hundred patients have some complication, and most are minor and temporary. Voice change occurs in fewer than one in a hundred, and almost always recovers on its own: permanent damage is described in fewer than two in a thousand cases.
No procedure is free of risk, and this one is no exception. What can be done is to reduce that risk: working with the electrode on screen the whole time, entering through the center of the neck and knowing exactly where that nerve runs. That knowledge of the anatomy of the neck is part of the work, and it is the reason a surgical oncologist performs this procedure.
Chung SR, Baek JH et al., International Journal of Hyperthermia 2017 (2,421 patients): complications 2.38 %; voice change 1.02 %; permanent nerve injury 0 to 0.17 %.
Two nuances
There are two nuances worth knowing.
Cystic nodules have another first line. When the nodule is mostly fluid, guidelines put ethanol ablation first, a simpler technique; radiofrequency is the next step. At the evaluation you are told which technique fits your nodule.
The biopsy has to confirm that the nodule is benign. One is enough when the ultrasound also classifies it as benign (TIRADS 2), and otherwise two concordant results are needed. Even so, no biopsy is infallible: in a series of 148 nodules treated with “confirmed” benignity, seven turned out to be cancer. That is why ultrasound follow-up is part of the treatment.
Thyroid ablation
This treatment suits some nodules, not every one.
There are established criteria, and they are what we will assess with you at your first consultation.
Probably yes, if
a biopsy confirmed the nodule is benign and, in addition,
- it measures more than two centimeters
- it causes discomfort when swallowing or speaking
- it is visible on your neck, and that affects you
- it has grown on follow-up scans
Probably not, if
- the ultrasound shows high-risk features
- the nodule is mostly fluid, because then the first option is a different, simpler technique
If you have a cancer diagnosis
In a very small papillary carcinoma with no nodes, the guidelines contemplate ablation in selected patients. If the cancer is larger than one centimeter or has spread, surgery is what is indicated, and Dr. Jacobo performs it himself.
Surgery or ablation
What changes between one and the other.
Both are valid, but they answer different situations.
Conventional surgery
- Neck incision and visible scar
- General anesthesia and hospitalization
- May require hormone for life
- Weeks of recovery
- Removes the whole nodule, and is what is indicated for most cancers
Radiofrequency ablation
- No incision and no scar
- Local anesthesia, outpatient
- Keeps the gland and its function
- Back to routine in one or two days
- Shrinks the nodule, does not remove it. Indicated for benign nodules and, in selected cases, a very small papillary cancer
Your biopsy, together with the ultrasound, determines which of the two applies to you.
Before and after
This nodule was treated without surgery.
Radiofrequency ablation treats the nodule with a fine electrode guided by ultrasound, under local anesthesia and with same-day discharge, and it leaves no scar. Before the treatment, this patient's nodule was visible to the naked eye; five months later, it no longer shows.
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Afterwards
You return home the same day.
- 01You are discharged the same day, with no stitches or dressing.After a brief period of observation, you return home.
- 02What it takes most people to return to their routine.There may be neck discomfort or a bruise for a few days; managed with common pain relievers.
- 03The nodule does not disappear immediately: the body reabsorbs it.Ultrasound checks in the first year are part of the treatment, and then every year or two.
The same-day and return-to-routine timelines are Dr. Jacobo's indication; the reduction and follow-up, those of the guidelines.
What it costs
The cost of your case is given in writing at the evaluation.
The visit includes the review of your studies and the explanation of which options correspond to your case, even if none is with us. The procedure depends on the size of the nodule and the center where it is performed, and the cost is given to you in writing at the evaluation, itemized, before you decide anything.
Google reviews
5.046 reviewsSee on GooglePatient reviews.
Thyroid and cancer surgery patients, and patients from abroad, tell how their experience with the doctor was.
I want to express my deepest gratitude to the doctor for being my guide and support during one of the most difficult times of my life: my thyroid cancer treatment. From…
Yaskira PerezMay 2026Dr. Jacobo is highly professional, skilled, and incredibly kind. He takes the time to explain every step and every procedure, ensuring his patients have no unanswered…
Rosemil OvalleFebruary 2025Dr. Jacobo is an excellent professional with world-class attention to detail. When treating a close relative with thyroid surgery, at a leading center in the field, he…
Anthony TejadaJanuary 2025Wonderful doctor. I had no idea I'd been suffering from thyroid problems for some time, and you gave me an accurate diagnosis that changed my life. Thank you so much…
Ana AguileraJanuary 2025I had a total thyroidectomy performed by Dr. Jacobo. It was a difficult surgery, but I came out of the operating room feeling excellent. Dr. Jacobo loves what he does…
Sheila Sabrina Calderon cuelloJune 2025I am incredibly grateful for the care I received from Dr. Jacobo. I initially found him through a Google search while looking for alternative treatment options for my…
Kate LockhartMarch 2026My husband was diagnosed with colon cancer. Amidst our worry, we chose Dr. Jacobo because I was struck by his genuine and selfless interest in my husband's diagnosis. He…
Nidia AcostaSeptember 2025Dr. Joan is a physician with outstanding professional training and a true calling: compassionate, approachable, and always attentive, not only to his patients but also to…
Andi AlmanzarSeptember 2025I recently underwent surgery by Dr. Joan Jacobo, and there's nothing better than the safety and peace of mind for a patient and family, ensuring their health is in the…
Omar Encarnación UlloaSeptember 2025An excellent doctor, my dear Dr. Jacobo. After seeing many doctors without a clear answer about what was wrong with me, I finally found Dr. Jacobo. With great care and…
Alexandra Fontana ReynosoJanuary 2025I want to express my sincere gratitude to the doctor for his excellent work and dedication. From the very first moment, he instilled confidence, security, and a human…
Josmeiry PaulinoMarch 2026Dr. Joan Jacobo studied and performed a brain scan for my mother, and the experience was much more bearable thanks to his wonderful professional and, above all, humane…
Anibelka MenaApril 2024I want to highlight Dr. Joan's excellent service, experience, and dedication to his patients. Personally, I want to emphasize that few doctors dedicate the time, care…
Massiel LizardoJuly 2025Dr. Jacobo is a specialist who inspires great confidence and security. He knows how to soothe the anxiety that comes with having to see him! He's a doctor at the…
Jenny Guzman De GonzalezApril 2024Dr. Joan Javier Jacobo is an excellent oncology professional. He is highly qualified and recommended by other oncologists in the country. I wholeheartedly recommend him.…
Angelica MejiaAugust 2024Dr. Joan Javier Jacobo is an excellent professional and physician with a genuine and compassionate nature that is highly effective for his patients. I, his patient for…
Mariela Jiminian CamiloApril 2024An excellent doctor, dedicated to his patients, providing exceptional care with love and dedication. You are a doctor who inspires confidence; all patients should have an…
Jisselle PaulinoFebruary 2025An excellent professional, ethical, committed, and approachable. A doctor who, in addition to being highly qualified, provides his patients with peace of mind…
Mercedes RosarioJune 2025My dear Dr. Jacobo, for me you are an excellent doctor, kind, gentle, and a great professional. I had kidney surgery performed by him and I feel very well. I bless you…
Margaret CastrillonJanuary 2025Dr. Joan took the time to listen attentively, answer all my questions, and explain everything clearly and calmly. I felt heard, well cared for, and in good hands…
Lizvanessa JavierApril 2026
About the procedure
What people ask about the procedure.
In most cases, one. In large nodules, or nodules in both lobes, a second may be needed; we let you know before we begin, with its cost.
Benign, confirmed by biopsy, that cause symptoms, show or have grown. Also the nodule that produces too much hormone. In a very small papillary carcinoma without lymph nodes, the guidelines contemplate ablation in selected patients. If the cancer is larger than one centimeter or has spread, surgery is what is indicated.
It happens in one to two out of ten in long-term follow-up. It is detected at the ultrasound checks, and at that point it is decided with you: a second session or, in some cases, surgery.
Ultrasound checks during the first year and then every year or two. If you live abroad, the ultrasound can be performed in your country and Dr. Jacobo reviews it.
It is performed under local anesthesia. During the procedure you feel warmth or pressure; the discomfort can radiate to the jaw or the ear. Afterwards, common pain relievers are enough for two or three days.
The ultrasound and the biopsy if you already had them, and the thyroid labs. Before the procedure, a blood count, coagulation tests and a cardiology check are requested, and they are performed here.
Locations
Choose the center closest to you.
Santo DomingoClínica Abreu
In Gazcue, in the center of the capital, about 35 minutes from the airport. The clinic's first radiofrequency ablation session took place here.
San Francisco de MacorísCentro Médico Siglo 21
Office in suite 106, for patients in the northeast who prefer not to travel to Santiago.
The evaluation determines whether your nodule can be treated this way.
We invite you to present your ultrasound and your biopsy. In person in Santiago or Santo Domingo, or virtual from wherever you are; the full cost of your case is given to you in writing at the evaluation.