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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.
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
- Physical examination: You will be physically examined by the doctor. Your symptoms, medical history, and family history are noted.
- Blood tests: The blood tests help in checking the levels of the thyroid hormones, and diagnosis of any thyroid disorders.
- 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.
- Biopsy: The doctor will excise a sample of the thyroid tissue to check for the presence of cancer cells.
- 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.
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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.
Types:
The different types of thyroidectomy are:
- Partial thyroidectomy: The procedure involves the removal of a part of the thyroid gland.
- Complete thyroidectomy: The procedure involves complete removal of the thyroid gland.
Symptoms
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
Diagnosis
- Physical examination: You will be physically examined by the doctor. Your symptoms, medical history, and family history are noted.
- Blood tests: The blood tests help in checking the levels of the thyroid hormones, and diagnosis of any thyroid disorders.
- 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.
- Biopsy: The doctor will excise a sample of the thyroid tissue to check for the presence of cancer cells.
- 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).
Treatment
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.
Risks
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
After Procedure
- 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.
FAQ Section
The thyroid gland is a butterfly-shaped organ located at the base of your neck and composed of two cone-like lobes or wings. The gland regulates metabolism by secreting hormones, and when diseases affect the thyroid, its size or activity may become abnormal. Thyroidectomy is the removal of all or part of your abnormal thyroid gland.
There are three ways to perform thyroidectomy:
- Conventional thyroidectomy: It involves making an incision in the center of the neck to directly access the thyroid gland.
- Endoscopic thyroidectomy: This method uses smaller incisions in the neck. Surgical instruments and a small video camera are inserted through these incisions, and the camera guides your surgeon through the procedure.
- Robotic thyroidectomy: This is performed either through incisions in your chest and armpit or via an incision high in your neck. The robotic approach allows a thyroidectomy to be performed while avoiding an incision in the center of the patient's neck.
Total thyroidectomy procedures can take 3 to 4 hours, in most cases. The surgeon makes a small incision in the front of the neck and must carefully work around vital structures, such as the vocal nerves.
- Bleeding or infection
- Difficulty breathing
- Permanent hoarseness or weak voice
- Injury to parathyroid glands that can cause low blood calcium levels and sometimes muscle spasms or
- other neuromuscular symptoms.
Common Post-Surgery side effects are:
- Neck tension and tenderness
- Voice problems
- Swallowing problems
- Irritated windpipe
- Less Common Post-Surgery complications are:
- Hematoma
- Decreased Parathyroid Hormone activity
- Recurrent Laryngeal nerve injury
All operations involve some pain and discomfort, but most patients are surprised at how comfortablevthey feel after the thyroidectomy. Although the patient should be able to eat and drink normally, thevmain complaint is a sore throat and trouble with swallowing. Most patients have a prescription for thevfirst few days in case they need it, but beware prescription pain medicine can make a person drowsy and constipated.
In general, the activity level depends on the amount of discomfort the patient experience. Most people return to work in a week or two and are allowed to drive as soon as their head can be turned comfortably without prescription pain pills, limitation for driver safety.
Most patients are admitted to the hospital on the morning of their thyroidectomy and are able to go home the next day but patients with thyroid cancer or overactive thyroids sometimes stay two days.
People who have:
- Thyroid cancer
- Hyperthyroidism (overactive thyroid gland)
- Large goiters causing symptomatic obstruction such as swallowing or breathing difficulties.
- Multi-nodular Goiter.
The patient should resume a normal balanced diet as tolerated and must drink plenty of fluids.
The patient is given general anesthesia and will be completely asleep during the operation.
The cost of thyroidectomy in India varies across different cities and hospitals.
| CITY | COST |
| Cost of Thyroidectomy in Mumbai | INR 60000- INR 65000 |
| Cost of Thyroidectomy in Bangalore | INR 59000- INR 64000 |
| Cost of Thyroidectomy in Delhi | INR 59000- INR 64000 |
| Cost of Thyroidectomy in Chennai | INR 58000- INR 63000 |
A. Thyroidectomy procedure is performed by a general surgeon.
A. Yes, thyroid problems may recur after thyroidectomy. The possibility of the thyroid gland growing back or the recurrence of benign (non-cancerous) or cancerous disorders of the thyroid gland is about 5 to 20% depending on the disease.
A. The patient is usually discharged from the hospital one or two days after surgery. Normally, the patient can resume work within a week, but strenuous physical activities should be avoided for at least two to three weeks. Complete recovery may take up to three to four months.
A. Partial thyroidectomy is the partial removal of the thyroid gland, whereas, total thyroidectomy involves the complete removal of the thyroid gland. Partial thyroidectomy is preferred over total thyroidectomy as it decreases the patient’s overall need for TSH, thyroxine, and other supplements. However, a patient undergoing total thyroidectomy will need daily hormonal supplements to replace the natural function of the thyroid gland.
A. Thyroidectomy has no effect on the life expectancy of a person. The quality of life of the person undergoing thyroidectomy could be slightly lower after surgery, however, certain medications and supplements will be prescribed to make the after-effects of the surgery manageable.
A. The head of the bed should be elevated at 30 to 45 degrees or you should sleep in a recliner at 30 to 45 degrees for the first three to four days after surgery to reduce swelling.
A. Yes, it is normal to have a sore throat and cough that lasts for up to five days after surgery. A soft diet and the use of lozenges may be useful to relieve the soreness. It is also normal to feel like there is a phlegm in your throat and that you need to cough. This occurs due to the irritation of the tube in the windpipe during surgery.
A. You should try to avoid sneezing for the first few weeks after thyroidectomy. If you feel like sneezing, let it come out of the mouth like a cough. Avoid excessive coughing as well after surgery.