Doctors for Thyroidectomy

Thyroidectomy is a surgical procedure performed to remove all or part of the thyroid gland. A thyroid gland is a small butterfly-shaped gland present in the front of the neck. It is an essential gland of the endocrine system that secretes important hormones. If the thyroid gland starts secreting excessive hormones, then it develops a condition called hyperthyroidism. A doctor suggests a thyroidectomy to remove the thyroid gland to inhibit the excess secretion of thyroid hormone. It is also performed to treat thyroid nodules and thyroid cancer.

In most cases, the patient returns home on the same day of the surgery, whereas in some cases, the patient is transferred to the recovery room to monitor the calcium level in the blood.

Diagnosis usually begins with a physical examination. The doctor asks about your medical history and the symptoms that you are experiencing. They also check the thyroid glands for any abnormalities. If the doctor suspects any abnormality, then they prescribe tests to understand the severity of the condition. Some standard diagnostic tests are as follows:

• Blood test: It helps measure the thyroxine (T4 hormone) and thyroid-stimulating hormones in the blood to determine the presence of thyroid issues.
• Chest X-ray: This is performed to diagnose substernal extension of the thyroid into the superior mediastinum.
• Ultrasound: This test helps in determining the state of thyroid nodules, whether they are solid or filled with fluid. It also helps in diagnosing the number and size of thyroid nodules.
• Magnetic resonance imaging (MRI): A doctor usually recommends this test if he/she suspects the formation of a tumor. It also looks for cancer in the thyroid or if it has spread to distant or nearby organs.

Thyroidectomy surgery begins by administering general anesthesia to induce relaxation, alleviate pain, and induce sleep. A surgeon makes a minor incision in the front of the neck and carefully dissects the thyroid gland. After that, the surgeon removes a portion or the entire thyroid gland, depending on the condition. If the surgeon suspects cancer, then they remove the thyroid gland along with the nearby lymph nodes. After removing the thyroid gland, the surgeon closes the incision by using stitches or staples. The patient is then shifted to a recovery room to look for any complications. After surgery, it is essential to follow all the post-surgery instructions and attend all the follow-up appointments to track the recovery.

Thyroidectomy is required to treat various health conditions, including,

• Goiter: It is a condition in which the thyroid gland becomes enlarged and makes breathing and swallowing hard. A doctor usually performs a thyroidectomy to remove the part of the thyroid gland to improve the breathing.
• Thyroid cancer: Thyroidectomy is an effective procedure in treating thyroid cancer. During the procedure, the doctor removes the thyroid gland, which inhibits the formation of tumors.
• Hyperthyroidism: If the thyroid gland starts secreting excess hormone, then it develops the condition of hyperthyroidism. In such conditions, a doctor performs a thyroidectomy to remove the gland and inhibit the production of the hormone thyroxine.
• Thyroid nodules: A doctor usually recommends thyroidectomy if the thyroid nodules are at risk of developing cancer.

There are three different types of thyroidectomy surgery:

• Partial thyroidectomy: In this surgical procedure, only a part of the thyroid gland is removed. The remaining intact portion performs the function of the entire thyroid gland. It is recommended to treat thyroid nodules and, in some cases, thyroid cancer. During the procedure, a surgeon makes a small incision in the neck to access the affected area and then removes it carefully.
• Complete thyroidectomy: During this procedure, a surgeon removes the entire thyroid gland. It is most commonly performed to treat thyroid cancer and other health issues such as multinodular goiters and grave disease. After the surgery, the body is no longer able to make thyroid hormones. A doctor recommends taking a pill every day that contains the synthetic thyroid hormone.
• Thyroid lobectomy (Hemithyroidectomy): During this procedure, one of the two thyroid lobes is removed. It is usually recommended to treat hyperthyroidism or if the thyroid nodules/lumps are limited to one lobe.
• Thyroid isthmusectomy: In this procedure, the thyroid lobe is removed along with the isthmus (the part that connects both lobes). This procedure is performed in patients with unilateral thyroid cancer to ensure all the cancerous tissues have been removed.

There are 3 different surgical techniques to perform thyroidectomy, including

• Conventional thyroidectomy: It is a traditional approach during which a surgeon makes a large incision in the center of the neck to access the thyroid gland.
• Transoral thyroidectomy: This technique does not require any incision; the surgeon directly inserts the surgical instruments through the mouth to remove the thyroid gland. The major advantage of transoral thyroidectomy surgery is that it leaves no scar on the neck as compared to conventional open thyroidectomy.
• Endoscopic thyroidectomy: It is a minimally invasive procedure in which a surgeon makes an incision on the neck and then inserts the endoscope (surgical instrument with camera and light on its head) through the incision. An endoscope helps guide the surgical instruments to remove the thyroid gland with minimum damage to the surrounding tissues.

Here are some steps to follow in order to prepare yourself for thyroidectomy surgery:

• Do consult a surgeon and discuss all the questions you have in your mind, including benefits, risks, and complications. If you are taking any supplements, over-the-counter medicines or any kind of drugs, inform your surgeon about that.
• Undergo detailed diagnostic tests to understand the severity of the condition and also identify any underlying health condition that might complicate the surgery.
• Quit smoking prior to the surgery, as it can increase the risk of anesthesia-related complications. It can also delay the recovery process after surgery. Avoid drinking alcohol 24 hours prior to the surgery.
• Before surgery, it is essential to stay physically fit. Do regular aerobic exercises, it helps in quick and smooth recovery post-surgery.

Here are tips to follow after thyroidectomy surgery to promote recovery:

• Gradually increase physical activity intensity to improve the blood flow and metabolic pathways. However, you must avoid strenuous physical activities such as heavy lifting, jogging, aerobic dancing, etc.
• Take proper care of the surgical site. Avoid using harsh chemical soaps around the incision to avoid the chances of complications.
• Take calcium supplements after surgery to prevent thyroidectomy hypocalcemia. You can incorporate yogurt and cheese into your diet as they are packed with calcium and other essential nutrients.
• Apply all the prescribed ointments on the scar to prevent it from drying and scabbing.
• Drink smoothies and soups and eat mashed foods after surgery to avoid the chances of constipation.
• While taking a shower, it is essential to keep your neck as dry as possible. You must avoid swimming for at least a week after surgery.

Moreover, it is essential to follow all the post-surgery instructions provided by your healthcare provider for a swift and smooth recovery. If you notice any signs of infection, then contact your healthcare without any further delay.

Some common risks and complications associated with thyroidectomy surgery are as follows:

• Nerve injury: During the surgery, there is a risk ofinjury to the recurrent laryngeal nerve that can lead to temporary or permanent hoarseness and acute respiratory distress.
• Neck pain: Sometimes, patients experience neck pain and hoarse or weak voice post-surgery. It usually occurs due to irritation in the breathing tube that is inserted into the windpipe during surgery.
• Vocal cord damage: During thyroid surgery, there is a risk of vocal cord damage as it is located close to the thyroid glands. The damage can lead to hoarseness or even voice loss. It is a temporary side effect that usually resolves over time.
• Infection: There is a risk of infection post-surgery. It usually occurs from the drainage of the infected fluid. A doctor usually prescribes antibiotics to treat the infection.

Listed below are some questions to ask your surgeon before thyroidectomy surgery to have a better understanding of the procedure and the risks and complications associated with it:

• What is the success rate of thyroidectomy surgery?
• What are the risk factors for thyroidectomy surgery?
• What are the different types of thyroidectomy surgery?
• What are the long-term side effects of thyroidectomy surgery?
• What are the risks and complications associated with thyroidectomy surgery?
• What is the recovery period after thyroidectomy surgery?
• How long does it take to recover after thyroidectomy surgery?
• What precautions do I need to take after thyroidectomy surgery to promote healing?
• Who is the right candidate for thyroidectomy surgery?
• How long is the hospital stay after thyroidectomy surgery?
• What are the physical restrictions after the surgery?
• What are the benefits of thyroidectomy surgery?
• What are the voice exercises after thyroidectomy?
• What supplements do I need to take after thyroidectomy surgery?
• How can I prepare myself for thyroidectomy surgery?
• What are the other treatment options except surgery?
• Is thyroidectomy a major procedure?

The cost of thyroidectomy surgery in India typically ranges from around INR 70,000 to INR 95,000. This is the estimated cost of surgery; the final cost can vary depending on various factors, including:

• Choice of hospital
• Type of surgical procedure
• Amount of thyroid tissues to be removed
• City of the treatment
• Patient’s age, gender, and health condition
• Post-surgical care and management/prevention of possible complications
• Surgeon’s fees
• Cost of diagnostic tests
• Insurance coverage