What is a thyroidectomy. How is the procedure performed. What are the potential risks and complications. How long does recovery take. What happens after thyroid removal. Who might need this surgery. How to prepare for a thyroidectomy.

What is a Thyroidectomy and Why is it Performed?

A thyroidectomy is a surgical procedure that involves the removal of all or part of the thyroid gland. The thyroid, a butterfly-shaped gland located in the front of the neck, plays a crucial role in regulating many of the body’s critical functions through the production of thyroid hormones.

There are several reasons why a person might need a thyroidectomy:

• Thyroid cancer
• Thyroid nodules
• Hyperthyroidism (overactive thyroid)
• Goiter (enlarged thyroid gland)
• Suspicious growths or tumors

In cases of hyperthyroidism, the thyroid gland produces an excess of thyroid hormone. This condition can result from various factors, including:

• Autoimmune disorders
• Excessive iodine intake
• Benign pituitary gland tumors
• Overuse of thyroid medication
• Inflammatory processes affecting the thyroid

Types of Thyroidectomy Procedures

There are two main approaches to performing a thyroidectomy:

1. Traditional Thyroidectomy

In a traditional thyroidectomy, the surgeon makes an incision in the front of the neck, typically placed in a natural skin crease to minimize visible scarring. The procedure involves the following steps:

1. The patient is placed in a semi-seated position, sometimes with the chin tilted back.
2. General anesthesia is administered, ensuring the patient is asleep and pain-free during the surgery.
3. A small incision is made in the neck skin.
4. The surgeon carefully separates a thin layer of muscle to access the thyroid gland.
5. One or both lobes of the thyroid gland are removed, along with any affected lymph nodes if necessary.
6. The muscles are returned to their proper position and secured.
7. The skin incision is closed using sutures or surgical glue.

2. Scarless (Transoral) Thyroidectomy

A more recent innovation in thyroid surgery is the scarless or transoral thyroidectomy. This technique involves accessing the thyroid gland through the mouth, resulting in no visible external scarring. While this approach may be appealing for cosmetic reasons, it’s important to note that it may not be suitable for all patients or thyroid conditions.

Preparing for a Thyroidectomy: Pre-Operative Steps

Before undergoing a thyroidectomy, patients will need to complete several pre-operative steps to ensure the best possible outcome:

Imaging and Laboratory Tests

Your doctor will order a series of tests to assess your thyroid function and overall health:

• Thyroid imaging: This may include ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) to visualize the thyroid gland and surrounding structures.
• Blood tests: These will measure thyroid hormone levels and other relevant factors.
• Laryngoscopy: An examination of the vocal cords using a specialized instrument called a laryngoscope.

Medication Management

Depending on your specific condition and overall health, your healthcare team may administer certain medications before the procedure:

• Antibiotics: For patients with weakened immune systems or those at higher risk of infection.
• Antiemetics: To reduce nausea and vomiting associated with anesthesia.
• Thyroid hormone balancing medications: For patients with hyperthyroidism, to ensure hormone levels are stable during and after surgery.

Potential Risks and Complications of Thyroidectomy

While thyroidectomy is generally considered a safe procedure, it’s important to be aware of potential risks and complications:

• Voice changes, including hoarseness
• Sore throat
• Bleeding and blood clots
• Formation of adhesions or scar tissue that may require additional surgery
• Injury to the esophagus or trachea
• Hypoparathyroidism (insufficient parathyroid hormone production)

Hypoparathyroidism is a particular concern, as it can lead to abnormally low blood calcium levels. This condition may be temporary or permanent, depending on the extent of the surgery and individual factors.

Recovery and Post-Operative Care After Thyroidectomy

The recovery process after a thyroidectomy can vary depending on the extent of the surgery and individual factors. Here’s what patients can typically expect:

Immediate Post-Operative Period

Some patients may be able to return home on the same day as the surgery, while others may need to spend a night in the hospital for observation. During this time, medical staff will closely monitor vital signs and blood calcium levels.

Pain Management

It’s normal to experience some discomfort in the neck area following the procedure. Your healthcare team will provide appropriate pain management strategies, which may include over-the-counter or prescription pain medications.

Incision Care

If you’ve had a traditional thyroidectomy, you’ll need to keep the incision site clean and dry. Your surgeon will provide specific instructions on wound care and when you can resume normal activities like showering.

Voice Rest

To protect your vocal cords and promote healing, you may be advised to rest your voice for a period of time after the surgery. This may involve speaking softly or minimizing unnecessary talking for a few days.

Long-Term Management: Thyroid Hormone Replacement Therapy

Following a total thyroidectomy, patients will require lifelong thyroid hormone replacement therapy. This is because the body can no longer produce its own thyroid hormones once the gland has been removed.

What is thyroid hormone replacement therapy?

Thyroid hormone replacement therapy involves taking synthetic or naturally derived thyroid hormones in pill form. The most common medication used is levothyroxine, which mimics the action of the thyroid hormone thyroxine (T4).

How is the dosage determined?

The appropriate dosage of thyroid hormone replacement is highly individualized. Your endocrinologist will perform regular blood tests to monitor your thyroid hormone levels and adjust the medication as needed. It may take some time to find the optimal dose that keeps your body’s functions in balance.

What happens if the dose is incorrect?

If the dose of thyroid hormone replacement is too low, you may experience symptoms of hypothyroidism, such as fatigue, weight gain, and cold intolerance. Conversely, if the dose is too high, you might develop symptoms similar to hyperthyroidism, including anxiety, rapid heartbeat, and weight loss.

Advancements in Thyroid Surgery: Scarless Techniques

As surgical techniques continue to evolve, new approaches to thyroidectomy are being developed to minimize visible scarring and potentially improve patient outcomes.

Transoral Endoscopic Thyroidectomy

This innovative technique involves accessing the thyroid gland through small incisions made inside the mouth. The benefits of this approach include:

• No visible external scarring
• Potentially faster recovery times
• Reduced risk of certain complications associated with traditional neck incisions

However, it’s important to note that transoral thyroidectomy is not suitable for all patients or thyroid conditions. Factors such as the size of the thyroid gland, the presence of cancer, and individual anatomy can influence whether this approach is appropriate.

Robotic-Assisted Thyroidectomy

Some medical centers now offer robotic-assisted thyroidectomy, which can provide surgeons with enhanced precision and visualization during the procedure. This technique may involve:

• Small incisions in the armpit or chest area to access the thyroid
• Use of a robotic surgical system to manipulate instruments and remove the thyroid gland
• Potential benefits such as reduced scarring and faster recovery times

As with any surgical innovation, these advanced techniques require specialized training and may not be widely available. Patients should discuss all available options with their healthcare team to determine the most appropriate approach for their individual case.

Living Without a Thyroid: Long-Term Considerations

After a total thyroidectomy, patients will need to adjust to life without a functioning thyroid gland. While thyroid hormone replacement therapy can effectively manage most symptoms, there are some long-term considerations to keep in mind:

Regular Monitoring

Patients will need to have their thyroid hormone levels checked regularly, typically every 6-12 months once a stable dose is established. This may involve blood tests and occasional adjustments to medication dosage.

Medication Adherence

Taking thyroid hormone replacement medication consistently and as prescribed is crucial for maintaining overall health and preventing complications. Patients should develop a routine for taking their medication, usually on an empty stomach in the morning.

Dietary Considerations

While there’s no specific “thyroid diet,” some dietary factors can affect thyroid hormone absorption. Patients should be aware of potential interactions between their thyroid medication and certain foods or supplements, such as:

• Iron and calcium supplements
• High-fiber foods
• Soy products

It’s generally recommended to take thyroid medication on an empty stomach and wait at least an hour before eating or taking other supplements.

Ongoing Cancer Surveillance

For patients who underwent thyroidectomy due to thyroid cancer, ongoing surveillance will be necessary. This may involve regular check-ups, blood tests to monitor thyroglobulin levels (a marker for thyroid cancer), and occasional imaging studies.

Pregnancy Considerations

Women who have had a thyroidectomy and are planning to become pregnant should consult with their endocrinologist. Thyroid hormone requirements often increase during pregnancy, and close monitoring is essential to ensure proper fetal development.

Thyroidectomy vs. Alternative Treatments: Making an Informed Decision

While thyroidectomy is an effective treatment for many thyroid conditions, it’s not always the only option. Depending on the specific diagnosis and individual circumstances, alternative treatments may be considered:

Radioactive Iodine Therapy

For some cases of hyperthyroidism or small thyroid cancers, radioactive iodine therapy may be an alternative to surgery. This treatment involves taking a dose of radioactive iodine, which is absorbed by the thyroid gland and destroys overactive thyroid cells.

Medication Management

In cases of mild to moderate hyperthyroidism, long-term medication management with anti-thyroid drugs may be an option. This approach aims to control thyroid hormone production without removing the gland.

Active Surveillance

For small, low-risk thyroid cancers or benign nodules, a strategy of active surveillance (sometimes called “watchful waiting”) may be appropriate. This involves regular monitoring with ultrasounds and blood tests rather than immediate intervention.

Factors to Consider

When deciding between thyroidectomy and alternative treatments, patients and their healthcare providers should consider several factors:

• The specific thyroid condition and its severity
• The patient’s overall health and age
• The potential risks and benefits of each treatment option
• The patient’s preferences and lifestyle considerations
• The availability of experienced surgeons or specialized treatments

It’s essential for patients to have thorough discussions with their healthcare team, including endocrinologists and surgeons, to make an informed decision about the most appropriate treatment approach for their individual case.

The Future of Thyroid Surgery: Emerging Technologies and Techniques

As medical science continues to advance, new technologies and techniques are being developed to improve thyroid surgery outcomes and patient experiences. Some areas of ongoing research and innovation include:

Intraoperative Nerve Monitoring

Advanced nerve monitoring systems are being developed to help surgeons identify and protect the recurrent laryngeal nerves during thyroidectomy. These nerves control the vocal cords, and their preservation is crucial for maintaining normal voice function.

Artificial Intelligence in Surgical Planning

AI-powered imaging analysis tools are being explored to assist surgeons in preoperative planning and intraoperative decision-making. These technologies could potentially improve surgical precision and reduce complications.

Minimally Invasive Techniques

Researchers are continuing to refine and develop new minimally invasive approaches to thyroid surgery, aiming to reduce scarring, shorten recovery times, and improve cosmetic outcomes.

Tissue Engineering

In the more distant future, advances in tissue engineering and regenerative medicine may offer the possibility of growing replacement thyroid tissue. This could potentially eliminate the need for lifelong hormone replacement therapy after total thyroidectomy.

While these innovations are exciting, it’s important to note that many are still in the research or early implementation stages. Patients should discuss the latest available options with their healthcare providers to understand what might be appropriate for their specific situation.

Thyroidectomy | Johns Hopkins Medicine

Thyroidectomy is surgical removal of all or part of the thyroid gland, which is located in the front of the neck. The thyroid gland releases thyroid hormone, which controls many critical functions of the body.

What You Need to Know

• Thyroid cancer, thyroid nodules and other conditions may require thyroidectomy.
• Once the thyroid gland is removed, the person takes replacement thyroid hormone to keep the body’s functions in balance.
• Thyroidectomy can be performed through an incision at the front of the neck, or through the mouth (scarless thyroidectomy).

Why might I need a thyroidectomy?

A thyroidectomy may be appropriate for people who have a thyroid tumor, thyroid nodules or hyperthyroidism, which occurs when the thyroid gland produces too much thyroid hormone.

Hyperthyroidism can be the result of an autoimmune problem, too much iodine in the diet, a benign tumor in the pituitary gland, too much thyroid medication, a swelling (goiter) in the thyroid gland or an inflammatory process.

What are the risks of thyroidectomy?

• Voice changes, such as hoarseness
• Sore throat
• Bleeding and blood clots
• Adhesions or scar tissue that require another surgery
• Injury to the esophagus or trachea (windpipe)
• Hypoparathyroidism (too little parathyroid hormone, which can result in abnormally low blood calcium levels)

What happens during a thyroidectomy?

Before the Procedure

The doctor will order imaging and laboratory tests, including:

• Thyroid imaging with ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI)

• Blood test(s) for thyroid hormone levels and other factors

• Examination of the vocal cords using an instrument called a laryngoscope

Just before your procedure, the surgical team may give you an antibiotic if you have a weakened immune system or other condition that makes you prone to getting infections. You may receive medicines to reduce nausea and vomiting (antiemetics).

For people with hyperthyroidism, the doctor will administer medications to keep thyroid hormones in balance during and after surgery.

Types of Thyroidectomy

Traditional Thyroidectomy

In the operating room, you will be in a semi-seated position, with or without your chin tilted back and with support under your neck and shoulders. Most thyroidectomies are performed under general anesthesia, meaning you are asleep and pain-free during the procedure.

The surgeon makes a small incision in the skin of the neck as close to a natural crease as possible to reduce the appearance of the scar. The surgeon parts a thin layer of muscle to gain access to the thyroid gland, then removes one or both lobes of the thyroid gland as well as any nearby lymph nodes that may be affected by disease.

The surgeon then returns the muscles of the front of the neck to their proper position and secures them in place. The skin is closed with sutures or glue.

Scarless (Transoral) Thyroidectomy

A newer technique involves accessing the thyroid gland through the mouth. This surgery leaves no visible scar since there is no incision on the outside of the neck.

Thyroidectomy: Recovery and Next Steps

In some cases, patients return home the same day as the surgery, but some
people spend the night in the hospital. There, the team can observe the
patient and monitor calcium levels in the blood.

When the thyroid gland is surgically removed, the body still requires
thyroid hormone to keep vital functions in balance.

Thyroid hormone replacement therapy

involves taking synthetic or naturally derived thyroid hormones in pill
form.

Thyroidectomy – Procedure & Risks

By Julie Lynn MarksMedically Reviewed by Robert Jasmer, MD

Reviewed: October 23, 2015

Medically Reviewed

Removal of the thyroid may be necessary due to cancer, enlargement, or noncancerous growths on the thyroid.

A thyroidectomy is surgery to remove part or all of a person’s thyroid.

The thyroid is a butterfly-shaped gland located at the base of your neck. It helps regulate your body’s metabolism.

A thyroidectomy might be needed if you have:

• Thyroid cancer
• Noncancerous growths on the thyroid
• An enlarged thyroid
• An overactive thyroid

A total thyroidectomy is a procedure to remove the entire thyroid.

A partial thyroidectomy means that just a portion of the gland is taken out.

The Thyroidectomy Procedure

A thyroidectomy can take up to four hours, depending on the type of surgery you’re having.

Most of the time, general anesthesia is given. This means you won’t be conscious during the procedure.

A surgeon will make an incision in the middle of your neck, or several small cuts in or near the neck.

If you’re having a conventional thyroidectomy, the surgeon will remove part or all of your thyroid through the incision in your neck.

If you’re having an endoscopic or robotic thyroidectomy, the surgeon will use small instruments and a video camera to perform the procedure through tiny incisions.

A catheter may be placed in the area to help drain blood and fluids.

Before a Thyroidectomy

Before your thyroidectomy, your doctor may perform tests to determine if a growth on your thyroid is cancerous.

You may also undergo imaging tests to find exactly where the thyroid growth is located.

Tell your doctor about all medicines you take before your surgery.

You might need to stop taking certain drugs, such as Plavix (clopidogrel bisulfate), aspirin, Advil (ibuprofen), Aleve (naproxen), or Coumadin (warfarin), prior to your procedure.

Let your doctor know if you smoke. Smoking may slow down your recovery.

Your doctor may prescribe a thyroid medicine or iodine treatment for you to take one to two weeks before your thyroidectomy.

You’ll probably be told not to eat or drink anything for several hours before your surgery. Follow your doctor’s instructions carefully.

After a Thyroidectomy

If you have a catheter in your neck to drain fluid, it’s usually removed the morning after your surgery.

You’ll probably be able to go home the day after your thyroidectomy, but you could spend up to three days in the hospital.

The length of your stay will depend on your medical condition and recovery. You must be able to swallow liquids and pills before you can return home.

It will take about three to four weeks for you to fully recover from your surgery.

If you’ve had your entire thyroid removed, you’ll probably need to take thyroid hormone pills for the rest of your life.

Risks of a Thyroidectomy

Potential risks of a thyroidectomy include:

• Bleeding or infection
• Difficulty breathing
• Permanent hoarseness or weak voice due to nerve damage
• Injury to parathyroid glands (glands near the thyroid) or their blood supply, which can cause low blood calcium levels and sometimes muscle spasms or other neuromuscular symptoms

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Editorial Sources and Fact-Checking

• Thyroid gland removal; MedlinePlus.
• Thyroidectomy; Mayo Clinic.
• Thyroidectomy; Cedars-Sinai.

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Thyroidectomy – removal of the thyroid gland

Prices Doctors Our centers

Indications Contraindications Preparation Surgery Rehabilitation Complications Thyroidectomy at SM-Clinic

Thyroidectomy is a surgical operation that involves complete or partial excision of the thyroid gland. Intervention is one of the main methods of treatment of malignant and benign neoplasms of this organ.

Indications

The most common indications for thyroidectomy are:

• thyroid cancer;
• large benign neoplasms: adenoma, nodes, cysts;
• multinodular goiter;
• diffuse toxic goiter;
• Thyroid nodes that produce hormones (toxic nodes).

Surgery is also indicated in cases where the patient develops cancer, but there are contraindications for radioiodine therapy.

Contraindications

Intervention is low-traumatic and therefore has a minimum number of contraindications. Thyroidectomy is not performed if the patient is found to have:

• acute infectious diseases;
• chronic pathologies in the acute stage;
• blood clotting disorders.

Preparation

As part of the preparation, you need to undergo a comprehensive examination, which includes:

• consultation with the attending physician;
• consultation with an anesthesiologist;
• blood tests, including coagulogram;
• urine tests;
• electrocardiogram.

If necessary, additional laboratory or instrumental studies, consultations with highly specialized specialists are prescribed.

Tell the doctor in advance about the medications the patient takes regularly. It is important to inform about the presence of allergies. As part of the preparation, a course of antibiotics may also be prescribed.

Promotion! Free consultation with a surgeon about surgery

Take advantage of this unique opportunity and get a free consultation about elective surgery.

Operation

Any type of thyroid surgery is performed under general anesthesia. The patient is put into a state of sleep and does not feel anything during the operation.

After the anesthesia has taken effect, the surgeon makes a transverse incision at the base of the neck. The incision is made in such a way that in the future the scar merges with the skin fold and is as inconspicuous as possible. After that, depending on the goals of the operation, the surgeon removes the pathology along with the thyroid gland or part of it. One of the main goals is to preserve the parathyroid glands and the recurrent nerve, if they are not affected by the disease.

After removing the tissues, the surgeon sews up the wound, puts a drain. Depending on the extent of the surgeon’s actions, the operation takes from 45 minutes to 3 hours.

Rehabilitation

After the intervention, you must stay in the hospital under the supervision of medical staff. Pain in the neck and throat persist for several days. Painkillers prescribed by a doctor help to get rid of pain.

The term of hospitalization is determined individually and depends on the volume of surgical intervention, the patient’s well-being. Often, after 2-3 days, discharge and continued recovery at home is possible.

If a total thyroidectomy, that is, the total removal of the thyroid gland, has taken place, a person will develop hypothyroidism after the operation. Therefore, there will be a need for a lifelong intake of hormonal drugs. However, even in the case of not total, but partial thyroidectomy, the thyroid gland may also lose its functions, which will have to be replenished with the help of drugs. Despite lifelong hormone replacement therapy, after recovery, a person will be able to lead a normal life without uncomfortable restrictions.

Complications

Complications after the intervention are quite rare. Among the most common: postoperative bleeding, hypoparathyroidism (lack of calcium in the body). If the laryngeal nerve is damaged during the operation, the timbre of the voice changes. Restoration of the usual timbre takes from 3 to 12 weeks. The risk of nerve damage is less than 1%.

Thyroidectomy at SM-Clinic

Surgical intervention on the thyroid gland refers to technically complex operations. The result of such treatment largely depends on the skills of the doctor. To minimize the risks and achieve the maximum positive effect, therapy should be trusted only by experienced surgeons who are proficient in advanced operating techniques. These are the doctors who work in the SM-Clinic.

We have been operating on patients since 2009. Our doctors perform more than 8500 operations annually in 20 surgical directions. Our team consists of over 140 experienced operating doctors and 18 anesthesiologists, including 20 doctors and candidates of medical sciences.

On the basis of our clinic in St. Petersburg, you can undergo a comprehensive preliminary examination. Our patients have at their disposal 7 operating theaters with modern equipment and 25 comfortable hospital wards.

Call us at the phone number listed on the website to find out the price of thyroidectomy, get acquainted with the price list for other services or sign up for a consultation.

* You can read more about the conditions here – Treatment on credit or installments

Preliminary cost. The exact cost of the operation can only be determined by the surgeon during a free consultation.

Specialists in this field 5 doctors

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Mikhailov Aleksey Gennadievich

Surgeon, oncologist, mammologist, endocrine surgeon

Work experience: 22 years

Udarnikov, 19

m. Ladozhskaya

Marshal Zakharov, 20

metro station Leninskiy pr-t

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m. Prosveshcheniya

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Boyko Alexander Aleksandrovich

Oncologist, oncodermatologist “SM-Clinic”

Work experience: 12 years

Danube, 47

Dunayskaya metro station

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901 56
Grinevich Vladimir Stanislavovich

Surgeon, oncologist, mammologist, coloproctologist

Work experience: 27 years

Vyborgskoe shosse, 17

metro Prosveshcheniya

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Pfanenshtil Anatoly Viktorovich

Surgeon, mammologist and oncologist. Doctor of the highest category.

Work experience: 15 years

Dunaysky, 47

Dunayskaya metro station

Malaya Balkanskaya, 23

Kupchino metro station

Make an appointment 9000 3
Khokhlov Sergey Viktorovich

Surgeon, oncologist, coloproctologist

Work experience: 28 y.o.

Our offices in St. Petersburg

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Thyroidectomy

The thyroid gland is an important endocrine organ that secretes hormones to regulate metabolic processes, electrolytes, the function of the nervous and reproductive systems. However, the thyroid gland is prone to disease. Among all diseases of the endocrine glands, thyroid pathologies are in second place in prevalence. Thyroid diseases are diagnosed, according to statistics from the World Health Organization, in every tenth person. At the same time, cases of thyroid disease increase every year, which is explained by unbalanced nutrition, depressing environmental conditions, the influence of hereditary factors, and the lack of an effective system for preventing iodine deficiency. Not all thyroid diseases are subject to effective conservative therapy. As a result, partial or radical removal of the thyroid gland becomes the main method for a number of indications.

A thyroidectomy is an operation to remove the thyroid gland. To overcome certain diseases, such as cancer, surgery involves the removal of lymph nodes in the trachea. Combined surgery makes cancer treatment effective and reduces the risk of recurrence.

DIAGNOSTIC EXAMINATION

Diagnosis before thyroidectomy includes the following measures:

– study of the level of hormones in the body;

– ultrasound examination of the gland and lymph nodes to detect pathologies;

– biopsy;

– laryngoscopy;

– CT scan;

– genetic research.

When is a thyroidectomy needed?

Thyroidectomy is recommended in situations where other treatments have failed or in malignant tumors. Patients with asymptomatic nodes are not recommended to carry out surgical intervention, since it is enough for them to limit themselves to dynamic observation. Thyroidectomy is performed in patients who have progressing pathology or suspected malignant transformations.

THE VOLUME OF THE PLANNED OPERATION DEPENDS ON THE NATURE OF THE PATHOLOGY AFFECTING THE THYROID GLAND

– Total thyroidectomy to remove the entire thyroid gland;

– Subtotal thyroidectomy, it is assumed that almost the entire gland is excised, leaving small areas and zones of the location of the parathyroid glands;

– Hemithyroidectomy to remove half of the organ with an isthmus with limited nodes of one of the lobes.

Thyroidectomy

The doctor makes an incision in the front of the neck, clamps and ties up the blood vessels. The thyroid gland – completely or partially – is cut off from other tissues. To prevent bleeding, special clamps are used that are responsible for the process of burying the ends of the vessels. The incision is sutured, the edges of the skin are fastened. It is often necessary to install drainage tubes to prevent fluid accumulation.