Background 

Thyroid surgery as the name suggests involves surgery of the thyroid  by placing the standardised instruments of the thyroid diseases. Since Thyroid swellings are most common ailments seen in  all age groups of the females( more common and males with various array of the thyroid disease are present. With the advancements of techniques and improvisation of surgical skills the surgical results have become excellent with time. 

Indication of Thyroid  surgery 

1. Thyroid cancers 
2. Cystic disease of the thyroid 
3. Solitary Thyroid nodules 
4. Goitre ( Multi-nodular thyroid Disease) 
5. Retrosternal goitre disease 
6. Autoimmune thyroid disease 
7. Genetic and familial thyroid disease. 

Surgical procedures for thyroid disease 

1. Total thyroidectomy 
2. Subtotal thyroidectomy 
3. Hemithyroidectomy
4. Total thyroidectomy with modified radical neck dissection 
5. Endoscopic thyroidectomy ( usually done for small thyroid nodules) 

Technical Insights

Once you are planned for surgery the surgeon will explain all the details , it’s risk involved , informed consent and recovery protocols after  the surgery they are  planning to perform. Usually the length of the procedure will depend upon the extent of the surgery.  

1. Surgery is performed under General anaesthesia
2. Surgery is performed in supine position with extended neck position. 
3. Incision is planned according to the surgery to be performed. 
4. In cases of total/ subtotal thyroidectomy, the thyroid gland is removed with careful dissection and preservation of laryngeal  nerves and parathyroid glands. 
5. The thyroid gland is an extremely vascular gland so extreme care taken to prevent any major bleeding. 
6. The diseased part is removed and drain is placed according to extent of resection to remove excess of fluid after surgery.
7. Vocal cord movements are assessed immediately after laryngeal airway is removed to check vocal cord paralysis. 

Recovery after surgery 

1. The patient might be kept in surgical post operative recovery unit for initial observation and management. 
2. Bleeding, infection of the wound  and seroma ( collection of fluid ion the operative area) are the risks involved with this surgery. 
3. Diet is usually give once patient is comfortable sitting with support.
4. After surgery, calcium and parathyroid and thyroid levels are assessed at routine intervals for need of supplementation. 
5. Early mobilisation of the patient is recommended.
6. Patients are usually discharged in 1-2 days. 
7. Dressing  needs to be changed as advised by your clinician 
8. Follow up treatment in form of medications is very important in cases after thyroid surgery. 

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