60210 Partial thyroid lobectomy, unilateral; with or without isthmusectomy

Name of the Procedure:

Partial Thyroid Lobectomy, Unilateral; with or without Isthmusectomy

Summary

A partial thyroid lobectomy is a surgical procedure in which only one lobe of the thyroid gland is removed. It may or may not include the removal of the isthmus, the thin tissue connecting the two lobes.

Purpose

Medical Condition

The procedure addresses conditions such as thyroid nodules, goiters, or thyroid cancer.

Goals

The goal is to remove problematic tissue while preserving as much normal thyroid function as possible.

Indications

• Suspicious or cancerous thyroid nodules
• Benign thyroid nodules causing symptoms
• Large goiter causing compression symptoms
• Overactive thyroid nodule (toxic adenoma)

Preparation

• Fasting: Patients are usually required to fast from midnight before the procedure.
• Medications: Adjustments may need to be made for blood thinners or thyroid medications.
• Diagnostic Tests: Thyroid ultrasound, blood tests, and sometimes a fine-needle aspiration biopsy.

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: A small incision is made in the lower neck.
3. Tissue Removal: The surgeon carefully removes one lobe of the thyroid and possibly the isthmus.
4. Closure: The incision is closed with sutures or surgical glue. ##### Tools and Technology
   • Surgical scalpel
   • Hemostats
   • Retractors
   • Electrocautery for cutting tissue and controlling bleeding

Duration

The procedure typically takes 1 to 2 hours.

Setting

The procedure is usually performed in a hospital operating room or specialized surgical center.

Personnel

• Surgeon
• Surgical Nurse
• Anesthesiologist
• Operating Room Technician

Risks and Complications

• Infection
• Bleeding
• Damage to surrounding structures (e.g., nerves, parathyroid glands)
• Hypothyroidism
• Voice changes due to nerve damage
• Scar formation

Benefits

• Relief from symptoms caused by the thyroid condition
• Reduced risk of progression if the nodule is cancerous
• Preservation of partial thyroid function

Recovery

• Initial Recovery: 1-2 weeks
• Activity Restrictions: Avoid strenuous activity for at least 2 weeks
• Follow-up: Regular monitoring of thyroid function through blood tests

Alternatives

• Radioactive iodine therapy for hyperthyroidism or certain types of thyroid cancer
• Medications for managing thyroid hormone levels
• Total thyroidectomy for more extensive disease ##### Pros and Cons
• Pros: Non-surgical options can avoid risks of surgery.
• Cons: Medications and radioactive therapy may be less effective for large goiters or cancer.

Patient Experience

• During: The patient will be under general anesthesia and will not feel anything.
• After: Mild to moderate neck pain and discomfort, soreness, and possible temporary voice changes.
• Pain Management: Pain medications and over-the-counter analgesics as needed.
• Comfort Measures: Ice packs, keeping the head elevated, and following activity restrictions to promote healing.