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Thyroid Surgery and Thyroidectomy:

An In-Depth Look

By

Updated June 02, 2014

Thyroid Surgery and Thyroidectomy:
A newer technique, known as endoscopic thyroid surgery, involves using a small magnifying camera inserted in the neck. Carbon dioxide gas is pumped into the neck area to help make it easier to see and work on the gland. A second small incision is made, and a thin tube with a scalpel-like edge is inserted through that incision. This tube is the surgical tool that is used to remove the thyroid. Endoscopic surgery, because it involves two small scars of less than one inch, usually leaves less visible scarring, and allows a quicker return to normal activity. Sometimes, the entry point is under the arm -- known as axillary surgery.

Endoscopic surgery is not common, however, and you'll need to investigate to find a surgeon with experience doing these surgeries.

Most surgeons use dissolvable stitches, but you may want to ask your surgeon ahead of time which kind he plans to use, because the non-absorbable stitches actually tend to cause less scarring. If you have any history of allergic skin reactions to past stitches, you may also want to ask your doctor about using hypoallergenic suture material.

After the surgery, you will usually remain under observation at the hospital for at least 6 hours. If you are having outpatient surgery, you may be discharged after that point.

Before you are discharged, your incision is usually covered with a clear protective waterproof glue called colloidium. (This allows you to bathe or shower after the surgery.)

Rarely, if there is concern about bleeding or if the thyroid is very large and the surgery has left a large open space, a drain will be left in your wound to prevent fluid from accumulating. You'll need to return to the surgeon a few days later to have the drain removed.

After Your Surgery

Thyroid surgery is generally considered extremely safe. There are some common short-term side effects after thyroid surgery such as pain when swallowing, and neck stiffness. Most patients also become hypothyroid after surgery and require thyroid hormone replacement therapy. These issues are discussed in greater depth in the article on Recuperating After Thyroid Surgery .

While complications are not common, a few can result from thyroid surgery. These include hypoparathyroidism and hypocalcemia, and laryngeal nerve damage. Signs can include numbness and tingling around your lips, hands, and the bottom of your feet, muscle cramps and spasms, bad headaches, anxiety, depression, hoarseness, and difficulty speaking loudly. You can read more about it in Complications After Thyroid Surgery.

Mary Shomon, About.com's Thyroid Guide since 1997, is a nationally-known patient advocate and best-selling author of 10 books on health, including "The Thyroid Hormone Breakthrough: Overcoming Sexual and Hormonal Problems at Every Age," "The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss," "Living Well With Hypothyroidism: What Your Doctor Doesn't Tell You...That You Need to Know," "Living Well With Graves' Disease and Hyperthyroidism," "Living Well With Autoimmune Disease," and "Living Well With Chronic Fatigue Syndrome and Fibromyalgia." Click here for more information on Mary Shomon.

Sources:

Braverman, MD, Lewis E., and Robert D. Utiger, MD. Werner and Ingbar's The Thyroid: A Fundamental and Clinical Text. 9th ed., Philadelphia: Lippincott Williams & Wilkins (LWW), 2005.

Columbia Presbyterian Thyroid Center Web Site, Online.

Ku, Chun-Fan et. al. "Total thyroidectomy replaces subtotal thyroidectomy as the preferred surgical treatment for Graves' disease," ANZ Journal of Surgery, Volume 75 Issue 7 Page 528-531, July 2005 Online

Lal, Geeta et. al. "Should Total Thyroidectomy Become the Preferred Procedure for Surgical Management of Graves' Disease?" Thyroid, Jun 2005, Vol. 15, No. 6 : 569 -574 Online.

Moreno, Pablo, et. al. "Subtotal Thyroidectomy: A Reliable Method to Achieve Euthyroidism in Graves' Disease. Prognostic Factors," World Journal of Surgery , Volume 30, Number 11, November 2006 , pp. 1950-1956(7) Online

Rosato, L, et. al. "Complications of total thyroidectomy: incidence, prevention and treatment"Chir Ital. 2002 Sep-Oct;54(5):635-42.

Shomon, Mary J., Living Well With Hypothyroidism: What Yoru Doctor Doesn't Tell You That You Need to Know, 2nd Edition, HarperCollins, 2005, Online.

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