Thyroid Removal Surgery: Thyroidectomy

Introduction of Thyroid Removal Surgery

Thyroidectomy is a surgical procedure to remove part or all of the thyroid gland. The thyroid is truly a butterfly-shaped gland found at the centre of the neck. It supplies the important hormones that manage every element of your metabolism, from your heart rhythm to how rapidly you burn fat.

Thyroidectomy can be an option to treat certain thyroid conditions, like cancers, noncancerous enlargement within the thyroid (goiter), and over productive thyroid (hyperthyroidism).

How much of your thyroid gland is taken off throughout thyroidectomy depends upon the primary reason for surgical treatment. If only a part of the thyroid being removed (hemithyroidectomy), the thyroid may function normally just after surgical procedures. When the whole thyroid gland is removed (total thyroidectomy), you desire every day treatment with thyroid bodily hormone to modify your thyroid's all-natural run.

 

Indications of Thyroid Removal Surgery​

  • Thyroid cancer: Cancer is regarded as the common grounds for thyroidectomy. For those who have thyroid cancer malignancy, getting rid of most, if not all, of your thyroid gland will likely be a treatment option.

  • Noncancerous enlargement of the thyroid (goitre): Removing all or portion of the thyroid gland is an option if you have a large goitre that is uncomfortable or even causes trouble breathing as well as swallowing or possibly, in some instances, if the enlarged thyroid gland is causing hyperthyroidism.

  • Overactive thyroid (hyperthyroidism): Hyperthyroidism is a condition in which the thyroid gland produces an excessive amount of the bodily hormone known as the thyroxine. For those who have problems with antithyroid drugs and don't wish to undergo radioactive iodine therapy treatment, thyroid removal surgery may be an alternative.

  • Indeterminate or perhaps suspicious thyroid nodules: Some thyroid nodules can't always be identified as cancerous as well as non cancerous after evaluating a small sample from a needle biopsy. Medical professionals may recommend that people with these nodules have thyroidectomy if the nodules have an increased risk of being cancerous.

Risks and Complications of Thyroid Surgery

Thyroidectomy is generally a safe procedure. Though the risk is low, as with any surgery, thyroidectomy comes with a potential risk of complications which consist of:

 

  • Bleeding within the wound. Usually occurs 4-8 hours after the surgery.

  • Infection of surgical wound.

  • Reduced parathyroid hormonal levels (hypoparathyroidism) caused by surgical damage or deliberate removal of the parathyroid glands. These types of glands are located behind the thyroid and responsible for our blood calcium regulation. Hypoparathyroidism may cause numbness over lips of mouth, tingling sensation over fingers, or sometime muscle cramps due to low blood calcium level.

  • Air passage obstruction brought on by compression due to haemorrhage.

  • Temporary or permanent hoarse or weakened voice as a result of nerve damage.

What to expect


Surgeons typically conduct thyroidectomy during general anaesthesia (GA), so you won't be conscious during the operation. The anaesthesiologist will provide you with an anaesthetic drugs as a gas, for you to inhale and exhale through a face mask, and injects a drug solution into your vein. A ventilation tube will then be placed within your windpipe (trachea) to assist your breathing throughout the operation.

 

The surgical team will place several monitor leads on your body to help ensure your heart rate, blood pressure and blood oxygen (pulse oximetry) remain at safe levels during the entire operation. These monitors include a blood pressure level cuff on your arm and heart-monitor leads attached to your torso.

 

How is thyroid surgical procedures done?

As soon as you're unconscious (general anesthesia), the operating doctor makes a cut (incision) low in the center of your neck. That can often be positioned in a skin crease where it will be difficult to see right after the incision heals. Virtually all or a portion of the thyroid gland is then removed, depending upon the indication for the particular surgery.

 

The surgical incision is going to be situated on the front of the neck. It can be frequently possible for the operating surgeon to place the incision within the existing skin wrinkle. When the thyroidectomy scar heals, it will eventually appear to be part of the crease and thus camouflage it.

If you're having thyroidectomy as a result of thyroid cancer, the operating doctor may also take a look at and remove the lymph nodes group around the thyroid (central neck dissection).

 

Thyroidectomy often takes one to three hours to complete. It may take more or less time, depending upon the magnitude of the surgery required.

There are several ways to thyroidectomy, which includes:

Conventional thyroidectomy.This method consists of creating an incision in the center of your neck to directly gain access to your thyroid gland. The majority of people will probably be candidates for this particular method.
 

Transoral thyroidectomy. This approach avoids a neck incision by employing an incision inside of the mouth.
 

Endoscopic thyroidectomy. This approach uses smaller cuts in the neck area. Surgical tools and a small endoscopic-guided video camera will be introduced via the incisions. The camera will guide the surgeon through the operation.

Classification: Types of thyroid surgery:

  1. Total thyroidectomy (removing all of the thyroid gland)

  2. Lobectomy or hemithyroidectomy (removing one half of the thyroid gland)

  3. Near-total thyroidectomy (getting rid of most of the thyroid gland but leaving behind a little bit tissues on one side)

Published on 20 May 2021

Medically reviewed & updated on 1 Jun 2021

By Dr Cheong Jack Pein