Thyroidectomy Surgery in India

 

A thyroidectomy is the surgical removal of all or some of the thyroid gland. This surgery is used to treat benign thyroid nodules and large goiter (noncancerous enlargement of the thyroid). In most cases, thyroidectomy is the preferred treatment of thyroid cancer. A total thyroidectomy removes the entire thyroid, whereas a hemi-thyroidectomy removes a portion of the gland….

 

Reasons for Thyroid Surgery

Thyroid surgery is performed in a number of circumstances :-

as a treatment for thyroid cancer when an enlarged thyroid (goiter) or multiple nodules cause cosmetic, breathing or swallowing problems in a pregnant woman, when her hyperthyroidism is not controllable by antithyroid drugs, and requires immediate treatment….

 

 

Types of Thyroid Surgery

There are three main types of thyroid surgery : -

Total Thyroidectomy – Complete Removal of the Thyroid

 

This is the most common type of thyroid surgery, and is often used for thyroid cancer, and in particular, aggressive cancers, such as medullary or anaplastic thyroid cancer. It is also used for goiter and Graves’/hyperthyroidism treatment.

 

Subtotal/Partial Thyroidectomy – Removal of Half of the Thyroid Gland

 

For this operation, cancer must be small and non-aggressive — follicular or papillary — and contained to one side of the gland. When a subtotal or partial thyroidectomy is performed, typically, surgeons perform a bilateral subtotal thyroidectomy which leaves from 1 to 5 grams on each side/lobe of the thyroid. A Harley Dunhill procedure is also popular, in which there’s a total lobectomy on one side, and a subtotal on the other, leaving 4 to 5 grams of thyroid tissue remaining.

 

Thyroid Lobectomy – Removal of Only About a Quarter of the Gland

 

This is less commonly used for thyroid cancer, as the cancerous cells must be small and non-aggressive…..

 

 

How It’s Done

Both types of thyroidectomy are usually done under general anesthesia. However, if general anesthesia is too risky for a patient, local or regional anesthesia may be used to permit the patient to remain awake during the procedure. An intravenous (IV) line will be inserted into one of your veins to deliver fluids and medications….

Conventional thyroidectomy

 

In a conventional thyroidectomy, a 3- to 4-inch incision will be made through the skin in the low collar area of your neck (the lower front portion of your neck, above the collarbones and breast bone). Next, a vertical cut will be made through the strap-like muscles located just below the skin, and these muscles will be spread aside to reveal the thyroid gland and other deeper structures. Then, all or part of your thyroid gland will be cut free from surrounding tissues and removed….

 

Endoscopic thyroidectomy

 

A viewing instrument called an endoscope and small surgical instruments will be inserted into your neck through three or four small incisions. Each incision is about 3 millimeters to 5 millimeters long (less than ? inch). Then the surgeon will use a tiny camera on the endoscope to guide the instruments and remove your thyroid tissue. At the end of the procedure, your neck incisions will be closed with tiny stitches or surgical tape….

 

The Surgical Procedure

In the surgery, the surgeon will cut a 3- to 5-inch incision across the base of your neck in front. The skin and muscle are pulled back to expose the thyroid gland. The incision is usually made so that it falls in the fold of the skin in your neck, making it less noticeable.

Blood supply to the gland is “tied off,” and the parathyroid glands are identified (so that they can be protected). The surgeon then separates the trachea from the thyroid, and removes all or part of the gland….

 

Possible complications include : -

Hemorrhage (bleeding) beneath the neck wound ?     

If this occurs, the wound bulges and the neck swells, possibly compressing structures inside the neck and interfering with breathing. This is an emergency….

 

Thyroid storm ?   

 If a thyroidectomy is done to treat a very overactive gland (thyrotoxicosis), there may be a surge of thyroid hormones into the blood. This is a very rare complication because medications are given before surgery to prevent this problem….

 

 

 

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