What is a Total Thyroidectomy?
Total thyroidectomy is a surgical procedure that involves the removal of the entire thyroid gland, which is a butterfly-shaped gland present at the base of your neck. The thyroid gland produces hormones that control your metabolism.
Indications of Total Thyroidectomy
Your doctor may recommend a total thyroidectomy if you have:
- Well-differentiated thyroid cancer
- Toxic multinodular or obstructive goiter
- Medullary thyroid cancer (cancer affects the special cells in the thyroid that produce thyroid hormones)
- Thyroid cancer that has spread outside the gland
- Uncontrolled hyperthyroidism
- Thyroid cancer that has developed after radiation exposure
Preparation of Total Thyroidectomy
- Before the procedure, you will receive a complete medical evaluation and your doctor will discuss the surgery in detail.
- Your doctor will perform a physical exam and take a medical history.
- Talk to your doctor about the medicines you are taking prior to the procedure. Inform your doctor if you are allergic to any medicines or anesthesia.
- Do not eat or drink 6-8 hours before the surgery. Arrange for someone to drive you home.
Procedure for Total Thyroidectomy
- You will be given general anesthesia so you will be asleep.
- You will lie on your back with a shoulder roll placed under the neck to extend the neck.
- The surgeon makes a small incision in the lower center neck, about an inch long, once the general anesthetic has taken effect.
- The incision can often be placed in a skin crease where it will be difficult to see after the incision heals.
- All of the thyroid glands is then removed with care taken to ensure all important structures including nerves and parathyroid glands are not injured.
- The surrounding lymph nodes are carefully examined to check for the spread of cancer and removed if cancerous lesions are noted.
- It normally takes one to two hours for a total thyroidectomy. Depending on the extent of the surgery, it could take a longer or shorter amount of time.
Post-Operative Care of Total Thyroidectomy
You will be monitored after the procedure to see how you are recovering from the surgery and anesthesia. After surgery, eating and drinking maybe a little painful initially. Pain medication will be prescribed by your doctor. When you go home, you can resume your normal routine. However, you should wait for at least 2-10 weeks before performing demanding tasks such as heavy lifting or strenuous sports.
You will need to take thyroid hormone for the rest of your life. Blood tests will be performed by your doctor to confirm that you are receiving the proper dose of thyroid hormone. After thyroidectomy, you may also need to take calcium supplements to balance your calcium levels.
Risks of Total Thyroidectomy
As with any surgery, there is a minimal risk of complications with a total thyroidectomy. These include:
- Bleeding
- Infection
- Scar formation
- Injury to nerves
- Low parathyroid hormone levels due to damage to the parathyroid glands
