Most thyroid cysts are benign; however, they require aspiration if symptomatic or atypical on ultrasound scanning, and ablation with ethanol injection if recurrent. We have systematically studied the use of new safety technologies for surgical procedures, which protect both the surgeon and the patient. Here, we describe the use of one such technology, the reciprocating procedure device, which enables simpler, safer, more efficient and less painful thyroid cyst aspiration and therapeutic ablation.