60220 Total thyroid lobectomy, unilateral; with or without isthmusectomy

Name of the Procedure:

Total thyroid lobectomy, unilateral; with or without isthmusectomy

Summary

A total thyroid lobectomy, unilateral, involves the surgical removal of one entire lobe of the thyroid gland. The procedure may also include the removal of the thyroid isthmus, which is the tissue that connects the two lobes of the thyroid gland.

Purpose

This procedure addresses conditions such as benign thyroid nodules, thyroid cancer, or hyperthyroidism that affects one lobe of the thyroid gland. The goal is to alleviate symptoms, remove cancerous tissue, or reduce thyroid hormone production.

Indications

• Presence of a solitary thyroid nodule
• Low to moderate risk thyroid cancer confined to one lobe
• Hyperthyroidism unresponsive to medication
• Large benign goiter causing compressive symptoms

Preparation

• Follow fasting instructions as provided by your healthcare team, usually starting at midnight before the surgery.
• Adjust or discontinue certain medications, including blood thinners, as advised.
• Preoperative blood tests, neck ultrasound, and possibly a fine-needle aspiration biopsy.

Procedure Description

1. The patient is administered general anesthesia.
2. An incision is made in the neck, typically along a natural skin crease.
3. The surgeon carefully dissects the overlying tissues to expose the thyroid gland.
4. One entire lobe of the thyroid (unilateral) and possibly the isthmus are removed.
5. Blood vessels and thyroid tissue are cauterized or clamped to prevent bleeding.
6. The incision is closed with sutures or surgical glue.

Duration

The procedure typically takes around 1 to 2 hours.

Setting

This surgery is usually performed in a hospital operating room.

Personnel

• General or endocrine surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

• Bleeding and infection
• Damage to surrounding structures, such as the vocal cords or parathyroid glands
• Temporary or permanent hoarseness
• Low calcium levels if parathyroid glands are affected

Benefits

• Relief from symptoms caused by thyroid nodules or goiter
• Removal of cancerous tissue, reducing the risk of spread
• Potential resolution of hyperthyroidism symptoms
• Benefits can often be realized within a few weeks post-surgery

Recovery

• Stay in the hospital for 1 to 2 days post-surgery.
• Avoid strenuous activities and heavy lifting for several weeks.
• Follow-up appointments to monitor recovery and thyroid function.
• Temporary dietary adjustments and pain management as needed.

Alternatives

• Medication for hyperthyroidism or thyroid nodules
• Radioactive iodine treatment
• Partial thyroidectomy (removal of part of the thyroid lobe)
• Pros and cons depend on the exact medical condition being treated. Some alternatives may not be suitable for cancerous conditions.

Patient Experience

• Expect some discomfort and a sore throat post-surgery.
• Pain is generally managed with prescribed medications.
• Mild to moderate swelling and bruising around the incision site.
• Voice changes are possible but usually temporary.