Thyroidectomy

A surgical procedure done for the removal of a part or whole of the thyroid gland is known as a thyroidectomy.

A butterfly-shaped organ that is present at the base of the neck is known as a thyroid gland. It is made up of two cone-like wings or lobes.
The thyroid gland helps in the secretion of hormones and regulates the metabolism of the body, that is, the conversion of the food consumed into energy.

Know More About Surgery

Purpose:
Thyroidectomy is recommended in the following conditions:

  • Treatment of thyroid cancer
  • Hyperthyroidism (an overactive thyroid gland)
  • Indeterminate thyroid nodules (growth within the thyroid gland) having a high risk of being cancerous
  • Goiter (enlargement of the thyroid gland)

Symptoms: 

The following symptoms are associated with various thyroid disorders, which could require treatment in the form of a thyroidectomy:

1. Thyroid cancer

  • Change in voice
  • Soreness of throat
  • Difficulty in breathing
  • Cough 
  • A visible lump in the throat area
  • Pain in the throat, which may radiate to the ears

2. Goiter:

  • Soreness of throat
  • Cough
  • Throat enlargement
  • Change of voice
  • Difficulty in swallowing food
  • Breathing difficulties

3. Hyperthyroidism:

  • Unexplained weight loss
  • Hair loss or hair fall
  • Increased sensitivity to heat
  • Fatigue
  • Rapid heart rate
  • Sleep disturbances
  • Increased bowel movements
  • Irregular menstruation
  1. Physical examination: You will be physically examined by the doctor. Your symptoms, medical history, and family history are noted.
  2. Blood tests: The blood tests help in checking the levels of the thyroid hormones, and diagnosis of any thyroid disorders.
  3. Imaging tests: Imaging tests like ultrasounds, CT scans, and MRI scans help in determining the exact location of the thyroid growth, by providing clear images of the thyroid gland.
  4. Biopsy: The doctor will excise a sample of the thyroid tissue to check for the presence of cancer cells.
  5. Laryngoscopy: A tube, known as a laryngoscope, is inserted through the mouth into the throat to view the larynx (voice box) and the vocal cords (the folds of tissue present in the throat that helps in the creation of sound).

 

Thyroidectomy can be performed through different approaches- Conventional, Endoscopic and Robotic depending on the incisions and how invasive the procedure is. The procedure is generally done under general anesthesia, that is, the patient is asleep during the procedure. The procedure takes approximately 3 to 4 hours to complete and can be performed in the following ways:

1. Conventional   thyroidectomy:

  • The surgeon makes a single incision or cut in the center of the neck.
  • The thyroid gland is either removed completely, or a part of it is removed. 
  • In cases of thyroid cancer, the lymph glands are also removed. 
  • The incision is then closed by sutures (stitches).

2. Endoscopic thyroidectomy:

  • The surgeon makes small incisions in the neck region.
  • A tube with a camera on one end, known as an endoscope, and small surgical instruments are inserted through these incisions. 
  • The camera guides the surgeon to remove the thyroid gland. 
  • The incisions are closed by sutures.

3. Scarless thyroidectomy by laparoscopy:

  • Three or four incisions are made in the lower portion of the lip.
  • A tube with a camera on one end, known as a laparoscope, and surgical instruments are inserted through these incisions. 
  • The thyroid gland is removed without leaving behind any surgical marks.

4. Robotic Surgery:

  • The surgeon guides a robotic arm to make an incision transorally (in the mouth) or in the axillary (armpit) region. 
  • The thyroid gland is then removed partially or completely.
  • The incision is later closed using sutures.

There are several types of surgeries that can be carried out in order to cure the disorders of the thyroid such as: 

  • Lobectomy- The removal of only one lobe of the thyroid gland is known as lobectomy. It is carried out in the case of nodules that affect only one part of the gland.
  • Subtotal Thyroidectomy- This type of thyroidectomy involves the removal of the thyroid gland but preserves the thyroid tissue due to which the thyroid is still functional. Patients usually suffer from hypothyroidism after a subtotal thyroidectomy.
  • Total Thyroidectomy- The removal of the thyroid gland and tissue is known as Total thyroidectomy. This is necessary in the case of thyroid cancer and other disorders which affect the whole gland.
 

The complications of thyroidectomy may include:

  • Infection
  • Bleeding
  • Pain
  • Blood clot formation
  • Sore throat
  • Scar formation
  • Changes in voice 
  • Damage to the parathyroid glands, causing spasms of muscles and low calcium levels 
  • Injury to the food pipe (esophagus)
  • Injury to the windpipe (trachea)
  • Injury to the recurrent laryngeal nerves (nerves that are connected to the vocal cords)
  • Additional forms of treatment, like radioactive iodine treatment, required in case of thyroid cancer

 

  • The patient will be on a liquid and soft diet for a few days after the procedure.
  • The patient can go home on the same day of the procedure in case of minor surgery. In case of major surgery, the patient may need to stay in the hospital for a few days before being discharged.
  • Rest your head well and do not put any weight on the neck region.
  • You can resume your daily activities the day after the procedure, although complete recovery may take 3 to 4 weeks.
  • Strenuous activities and heavy lifting should be avoided for at least 10 days after the procedure.
  • The doctor may recommend taking painkillers after the procedure.
  • A follow-up appointment with the doctor is recommended 7 to 10 days after the procedure.
  • In the case of complete thyroidectomy, the doctor may recommend thyroid hormone replacement medications to be taken for the rest of the life. This helps in preventing hypothyroidism (an underactive thyroid).
  • In the case of partial thyroidectomy, the remaining portion of the thyroid gland takes over the function of the complete thyroid gland, and no hormone replacement therapy is required.

 

Thyroidectomy from one of the best multi-speciality hospital: Manipal Hospital Hebbal (Earlier Columbia Asia Hospital Hebbal), Hebbal, Bengaluru

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