Thyroidectomy

What is it?

Thyroidectomy is the operation to remove either half (hemithyroidectomy) or all of the thyroid gland (total thyroidectomy). The common indications for this are:

1. Thyroid cancer confirmed or suspected on a needle biopsy
2. Suspicious cells on the needle biopsy (usually half the gland is removed to confirm the diagnosis)
3. Thyroid nodule (or a multi-nodular goitre) that is causing symptoms- tightness sensation, swallowing difficulty, airway compression, pain
4. Hyperthyroidism (overactive thyroid)- such as and overactive nodule or Graves Disease that is difficult to control with medication

How is it done?

Thyroidectomy is performed under general anaesthesia. The operation is performed through a small incision at the lower part of the front of the neck. This incision is disguised as best as possible in a skin crease to aid with scarring. The thyroid gland (either half or all) is removed with very careful preservation of the parathyroid (calcium) glands and the nerve to the voice box (recurrent laryngeal nerve).

How do you avoid complications in thyroid surgery?

Protection of the nerves to the voice box is of the utmost importance in thyroid surgery. All patients undergoing thyroid surgery have examination of their voice box both before and after surgery using a tiny camera that passes down the nose. The American Thyroid Association recommends this assessment in its guidelines for thyroid surgery.

During surgery I use the following to protect the nerves:

• Magnification
• Meticulous surgical technique around the nerves
• Nerve monitoring - monitors electrical activity in the nerve to deliver real-time information about the function of the nerve during the operation

What happens after surgery?

Following thyroid surgery, you will be observed in a high-dependency ward, which allows close monitoring from the nursing staff. There is a small risk of bleeding in the first 24 hours after the operation. Thyroidectomy usually requires a 1-2 night stay in hospital. After the operation you may have a drain coming out of the neck. This collects any excess fluid and is removed when its drainage amount is minimal. If the whole thyroid gland is removed then you will be commenced on thyroid hormone replacement. Also the calcium levels will be monitored after the operation and there is a chance you may require calcium replacement.

Learn more:
Click here for more information on the anatomy and function of the thyroid and parathyroid glands

What do I do when I get home?

Like any surgery you need to avoid overly strenuous exercise. Normal daily activities are fine but anything above this should be avoided.

Read more detailed post-operative instructions.

When will I see you again?

I usually see you 1 week after surgery. At this time the results of the pathology from the operation will be available and we can discuss those. Also any stitches can be removed and I can review the appearance of the surgical site at that time.