Thyroid Surgery


The thyroid is a small gland shaped a like a butterfly. It’s located in the lower front part of the neck, just below the voice box. The thyroid produces hormones that the blood carries to every tissue in the body. It helps regulate metabolism (the process during which the body turns food into energy). It also plays a role in keeping the organs functioning properly and helping the body conserve heat.

Sometimes the thyroid produces too much hormone. It may also develop structural problems, such as swelling and the growth of cysts or nodules. Thyroid surgery may be necessary when these problems occur.

Thyroid surgery removes all or a portion of the thyroid gland. A doctor will perform this surgery in a hospital while the patient is under general anesthesia.



Reasons for thyroid surgery


The most common reason for thyroid surgery is the presence of nodules or tumors on the thyroid gland. Most nodules are benign, but some can be cancerous or pre-cancerous. Even benign nodules can cause problems if they grow large enough to obstruct the throat, or if they stimulate the thyroid to overproduce hormones (a condition called hyperthyroidism).
Surgery can correct hyperthyroidism. Hyperthyroidism is frequently the result of an autoimmune disorder called Grave’s disease. Grave’s disease causes the body to misidentify the thyroid gland as a foreign body and send antibodies to attack it. These antibodies inflame the thyroid, causing hormone overproduction.
Another reason for thyroid surgery is the swelling or enlargement of the thyroid gland. This is referred to as a goiter. Like large nodules, goiters can block the throat and interfere with eating, speaking, and breathing.


Types of thyroid surgery


There are several different types of thyroid surgery. The most common are lobectomy, subtotal thyroidectomy, and total thyroidectomy.


Lobectomy


Sometimes a nodule, inflammation, or swelling affects only half of the thyroid gland. When this happens, a doctor will remove only one of the two lobes. The part left behind should retain some or all of its function.


Subtotal Thyroidectomy


A subtotal thyroidectomy removes the thyroid gland, but leaves behind a small amount of thyroid tissue. This preserves some thyroid function. Many individuals who undergo this type of surgery develop hypothyroidism, a condition that occurs when the thyroid doesn’t produce enough hormones. This is easily treated with daily hormone supplements.


Total Thyroidectomy


A total thyroidectomy removes the entire thyroid and the thyroid tissue. This surgery is appropriate when nodules, swelling, or inflammation affect the entire thyroid gland, or when cancer is present.


How is thyroid surgery performed?


Thyroid surgery takes place in a hospital. It’s important not to eat or drink anything after midnight before your surgery.

When you arrive at the hospital, you’ll check in and then go to a preparation area where you’ll remove your clothes and put on a hospital gown. A nurse will insert an IV in your wrist or your arm to administer fluids and medication.

Before surgery, you’ll meet with your surgeon. They’ll do a quick examination and answer any questions you may have about the procedure. You’ll also meet with the anesthesiologist who will be administering the medicine that makes you sleep throughout the procedure.

When it’s time for surgery, you’ll enter the operating room on a gurney. The anesthesiologist will inject medicine into your IV. The medicine may feel cold or sting as it enters your body, but it will quickly put you into a deep sleep.

The surgeon will make an incision over the thyroid gland and carefully remove all or part of the gland. Because the thyroid is small and surrounded by nerves and glands, the procedure may take two hours or more.

You’ll wake up in the recovery room, where the staff will make sure you’re comfortable. They’ll check your vital signs and administer pain medication as needed. When you’re in stable condition, they’ll transfer you to a room where you’ll remain under observation for 24 to 48 hours.