Name of the Procedure:

Thyroidectomy, Total or Complete

Summary

A thyroidectomy is a surgical procedure to remove the entire thyroid gland. The thyroid is a butterfly-shaped gland located in the neck that produces hormones regulating metabolism.

Purpose

This procedure is performed to treat various thyroid conditions such as cancer, hyperthyroidism, large goiters, or suspicious thyroid nodules. The goal is to alleviate symptoms, remove cancerous tissue, and restore normal hormone levels.

Indications

• Thyroid cancer
• Persistent hyperthyroidism that is unresponsive to other treatments
• Large or symptomatic goiters causing difficulty breathing or swallowing
• Suspicious thyroid nodules with potential malignancy

Preparation

• Fasting for at least 8 hours prior to surgery
• Adjustment or discontinuation of certain medications (e.g., blood thinners)
• Preoperative blood tests and imaging studies like ultrasound or CT scans
• Possible fine needle aspiration biopsy to evaluate thyroid nodules

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the lower central part of the neck.
3. The surgeon carefully dissects and removes the entire thyroid gland while preserving important nearby structures such as the parathyroid glands and the recurrent laryngeal nerves.
4. The incision is then closed with sutures or surgical adhesive.

Advanced equipment such as harmonic scalpels or electrocautery devices may be used to minimize bleeding. Intraoperative nerve monitoring may also be employed to prevent nerve damage.

Duration

The procedure typically takes 2 to 3 hours.

Setting

Thyroidectomy is performed in a hospital’s surgical suite under sterile conditions.

Personnel

• A Board-certified surgeon, often specialized in endocrine or head and neck surgery
• An anesthesiologist
• Surgical nurses and technicians
• A pathologist (on standby for any unexpected tissue analysis)

Risks and Complications

• Infection
• Bleeding or hematoma formation
• Damage to the recurrent laryngeal nerve, leading to hoarseness or voice changes
• Hypocalcemia due to accidental removal or damage to parathyroid glands
• General risks of anesthesia (e.g., allergic reactions, respiratory issues)

Benefits

• Relief from symptoms associated with thyroid disorders
• Removal of malignant or suspicious tissue
• Improved quality of life and metabolic function

Recovery

• Hospital stay of 1-2 days
• Pain management with medications
• Guidelines for resuming normal activities and diet
• Regular follow-up appointments to monitor hormone levels and incision healing
• Possible lifelong need for thyroid hormone replacement therapy

Alternatives

• Radioactive iodine therapy for hyperthyroidism or small thyroid cancers
• Medication management for certain thyroid conditions

• Less extensive surgical options like lobectomy (removal of one thyroid lobe)

  Note: Each alternative comes with its own set of benefits, risks, and suitability depending on the patient's particular condition.

Patient Experience

Patients will be under general anesthesia during the procedure and will not feel any pain. Postoperatively, some discomfort and a sore throat are common, which can be managed with painkillers. Patients typically experience a marked improvement in symptoms within weeks post-surgery, although some may require thyroid hormone replacement and periodic monitoring.