Hemithyroidectomy
Hemithyroidectomy is thyroid operation where a complete lobe (right or left) is removed. Thyroid surgery is always performed under general anaesthetic with head extended slightly backwards. The horizontal incision is made in front of the neck in the midline in the skin crease. On average it is around 5cm in length, but it may be a bit longer or shorter. The thyroid gland is divided in the midline and complete lobe removed. This procedure is safe and has minimal risk of damaging either laryngeal nerves or parathyroid glands.
Following procedure, the incision is closed with dissolving sutures and then taped with steristrips. There are no sutures to come out. Following 2 weeks of having steristrips, these are removed and wound taped with micropore tape. Routine wound care involves placing micropore replacing tape over the wound every 7 days for 2 months. This will minimize the scarring.
To minimize post-operative pain, I always perform bilateral cervical nerve block with local anaesthetic. This will cause the front of the neck and bottom part of the earlobe to be numb. This block only lasts approximately 24hrs. This procedure is not that painful, and most patients are only on paracetamol and ibuprofen.
Total Thyroidectomy
It is thyroid operation where complete thyroid gland (both left and right lobes) are removed. under general anaesthetic with head extended slightly backwards. The horizontal incision is made in front of the neck in the midline in the skin crease. On average it is around 5cm in length, but it may be a bit longer or shorter. The thyroid gland is divided in the midline and complete lobe removed. This procedure is safe and has minimal risk of damaging either laryngeal nerves or parathyroid glands.
Following procedure, the incision is closed with dissolving sutures and then taped with steristrips. There are no sutures to come out. Following 2 weeks of having steristrips, these are removed and wound taped with micropore tape. Routine wound care involves placing micropore replacing tape over the wound every 7 days for 2 months. This will minimize the scarring.
To minimize post-operative pain, I always perform bilateral cervical nerve block with local anaesthetic. This will cause the front of the neck and bottom part of the earlobe to be numb. This block only lasts approximately 24hrs. This procedure is not that painful, and most patients are only on paracetamol and ibuprofen.
Isthmusectomy
It is a thyroid procedure where only isthmus is removed. Isthmus is middle part of the thyroid connecting both left and right lobes. This part sits right in front of trachea (windpipe). This procedure is only performed for removing thyroid nodule/s that are in the midline. It is not a common procedure.
Isthmusectomy is performed under general anaesthetic with head extended slightly backwards. The horizontal incision is made in front of the neck in the midline in the skin crease. On average it is around 3-4 cm in length, but it may be a bit longer or shorter. The thyroid gland is divided in the midline and complete lobe removed. This procedure is safe and has minimal risk of damaging either laryngeal nerves or parathyroid glands.
Following procedure, the incision is closed with dissolving sutures and then taped with steristrips. There are no sutures to come out. Following 2 weeks of having steristrips, these are removed and wound taped with micropore tape. Routine wound care involves placing micropore replacing tape over the wound every 7 days for 2 months. This will minimize the scarring.
To minimize post-operative pain, I always perform bilateral cervical nerve block with local anaesthetic. This will cause the front of the neck and bottom part of the earlobe to be numb. This block only lasts approximately 24hrs. This procedure is not that painful, and most patients are only on paracetamol and ibuprofen.
Near Total Thyroidectomy
It is very rare procedure these days, it was more common 20 and more years ago for treatment of goiter. It is a procedure where both lobes are almost completely removed. Only small amount of thyroid tissue is left on each side (5gs or so).
Minimally Invasive Thyroid Surgery
There are different definitions of this surgery, including robotic surgery, keyhole surgery, transoral (through mouth) surgery or surgery through smaller cut (incision) in the neck. When I perform minimally invasive thyroid surgery, I talk about surgery performed through smaller incision in the neck which is usually slightly more to one side. At the moment I believe that there are no surgeons in New Zealand performing robotic, keyhole or transoral thyroid surgery.
Robotic Surgery
It involves using a robotic system controlled by surgeon sitting at the desk with a computer system. This usually involves 5cm+ incision in the armpit. Robot is very expensive, over 1 million dollars just to buy. Disposable equipment (scissors, graspers, etc) cost $5000.00-10,000.00 dollars without including the cost of operating theatre, surgeon and all other hospital costs. So far there are no obvious benefits to patients of using robot to perform thyroid surgery.
Keyhole Thyroid Surgery
It is not very commonly performed. Mostly it is performed in Korea.
Transoral Thyroid Surgery
It is made through the incision in the mouth, just in front of the lower teeth. This to me looks like a promising procedure with regards to avoiding the incision in the neck. This is relatively new procedure and there are no long-term studies assessing its benefits. Reading early results of the studies published so far, this procedure looks promising.