What is total thyroidectomy?
Total thyroidectomy is the surgical removal of the whole thyroid gland and thyroid tissues due to various medical conditions affecting the thyroid gland that could lead to swelling, inflammation, or nodule formation. It is the treatment of choice for thyroid carcinoma.
In addition, total thyroidectomy is to cure other conditions, such as goitre (multinodular or substernal) and Graves’ disease.
Alternate Name of Total Thyroidectomy Surgery
Thyroid Gland Removal
How is Total Thyroidectomy Surgery Performed?
Being a surgical procedure, total thyroidectomy is done under general anaesthesia that will make you fall asleep and become insensitive to sensations within a few minutes. After that, the surgeon makes an incision on the neck around the area of the thyroid gland and carefully removes the entire gland while preventing damage to adjoining glands or nerves.
The vitals are monitored throughout the surgery. Once the patient regains consciousness and is stable, he is transferred to the observation room and kept under observation for approximately 1-2 days, depending on his condition.
Advanced techniques such as robotic thyroidectomy are also available where the entire thyroid gland is removed with the aid of a robot. These types of surgeries are very precise and reduce the risk of complications.
- Pre-operative tests: Before surgery, the patient must undergo a few blood tests, such as a complete blood count, basic metabolic profile, blood coagulation profile, and blood pregnancy test for women of reproductive age. In addition, a chest X-ray and electrocardiogram (ECG) may be advised by the doctor to rule out any cardiac or pulmonary complications.
- In cancerous cases, the doctor might recommend undergoing fiberoptic laryngoscopy or chest CT- scan to monitor other internal organs.
- The patient should have an empty stomach during the operation and should not eat or drink anything post-midnight, the day before the surgery. Anti-anxiety medications may be administered to calm the nerves.
- The patient should reach the hospital at least four hours before the surgery, as he will be admitted and kept under observation for some time before the surgery starts.
After the surgery, the patient might feel sore throat or pain for a few days but these usually resolve on their own. Anti-inflammatory medication or antibiotics are administered for a few days to avoid the risk of infection or inflammation. However, the patient should look for any signs of infections or inflammations, and seek medical attention.
Routine activities may be resumed within a week following the surgery; however, one should not indulge in strenuous exercises or heavy weight lifting. Typically, after removing the thyroid gland, the patient will be put on a thyroxine pill to maintain the hormonal balance. The patient may also be required to take these pills lifelong.
Risks For Total Thyroidectomy Surgery
- Blood loss: Usually, the surgery is safe; however, in complicated cases, excessive blood loss could occur and might require additional interventions.
- Injury: During the removal of the thyroid gland, an injury could occur to the adjoining parathyroid glands leading to calcium deficiency and muscle spasms or recurrent laryngeal nerve leading to voice hoarseness.
- Infection: Although the surgery is carried out in aseptic conditions, there are chances of an infection that could complicate the surgery and might require antibiotics.
Recovery after thyroid surgery is usually quick and without complications. However, the patient should always look for any signs of complications. He should follow up with the surgeon at the scheduled visit to ensure anticipated progress.
Incision care: The incision will be covered with a protective strip and the patient can go ahead with bathing or washing the hair; however, rubbing of the incision area must be avoided. The strip will go off in a few days on its own as the glue gets loose and then anti-scan lotions can be used over the incision lining.
In rare cases, one may experience bleeding or voice hoarseness, but these symptoms are also temporary and resolve on their own.
The doctor might put the patient on calcium supplements to overcome potential calcium deficiency due to parathyroid injury.