Thyroidectomy

What is a thyroidectomy?

A thyroidectomy is the surgical removal of a diseased thyroid gland. Your thyroid gland is located in the front of your neck, below your larynx (voice box). It consists of two lobes, one on each side of your trachea (windpipe). Your thyroid gland plays an important role in regulating your body's metabolism and calcium balance. A thyroidectomy is a treatment for a variety of diseases, disorders and conditions of the thyroid gland.

A thyroidectomy is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options available depending on your specific circumstances. You should consider getting a second opinion about all your treatment choices before having a thyroidectomy.

Types of thyroidectomy

The types of thyroidectomy procedures include:

• Lobectomy or partial thyroidectomy is the removal of one lobe or only a portion of your thyroid gland.
• Lumpectomy is the removal of only a small portion of your thyroid gland. This procedure is a treatment for small, benign (non-cancerous) thyroid nodules or cysts.
• Sub-total or near-total thyroidectomy is the removal of almost all of your thyroid gland, leaving behind a very small amount of thyroid tissue.
• Total or completion thyroidectomy is the removal of all thyroid tissue. A completion thyroidectomy refers to the removal of any remaining thyroid tissue after you have had a previous lobectomy or partial thyroidectomy.

Other procedures that may be performed

In addition to a thyroidectomy, your doctor may also perform one or more other procedures. This includes a lymphadenectomy or the removal or biopsy sampling of lymph nodes.  Your doctor may perform this procedure if you have or your doctor suspects that you have thyroid cancer.

Why is a thyroidectomy performed?

A thyroidectomy is a major surgical procedure that your doctor may recommend to treat a variety of diseases, disorders and conditions of the thyroid. Your doctor may only consider a thyroidectomy for you if other treatment options with less risk of complications have failed. Talk with your doctor about all of your treatment options and consider getting a second opinion.

Your doctor may recommend a thyroidectomy for:

• Benign (non-cancerous) thyroid tumors, nodules or cysts
• Goiter or an enlarged thyroid gland. Surgery may be recommended for a goiter that interferes with breathing and swallowing.
• Hyperthyroidism (overactive thyroid gland) when radioactive iodine and medications are not options
• Thyroid cancer
• Thyrotoxicosis, also called thyroid crisis or thyroid storm, is a sudden worsening of hyperthyroidism that can be life threatening.

How is a thyroidectomy performed?          

An endocrine or general surgeon will lead the surgical team and perform your thyroidectomy in a hospital or outpatient surgery setting. An endocrine surgeon is a surgeon who specializes in surgical treatment of endocrine diseases. Your endocrine system consists of glands that produce hormones. These hormones act as chemical messengers in your body to control different bodily functions.

Surgical approaches to thyroidectomy

Your surgeon may perform a thyroidectomy using one of the following approaches:

• Minimally invasive surgery is performed by inserting special instruments and an endoscope through a small incision in your neck. An endoscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your body to a video screen viewed by your surgeon as he or she performs the surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less damage to tissues and organs. Your surgeonwill make small incisions instead of a larger one used in open surgery. He or she can then thread surgical tools around structures and tissues instead of cutting through or displacing them as in open surgery.
• Open surgery is performed by making a three to four inch incision in your neck. An open surgery incision allows your surgeon to directly view and access the surgical area. Open surgery requires a larger incision and involves more cutting and displacement of muscle and other tissues. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery because it causes more trauma to tissues. Despite the potential for damage, open surgery may be a safer or more effective method for certain patients.