Advanced minimally invasive thyroidectomy for thyroid removal

Pristyn Care is one of the largest and most successful surgery providers in India. We have a large surgical network, thanks to which we provide advanced treatment for a variety of diseases, including thyroid disease and other ENT problems.

At Pristyn Care, we have a team of expert ENT specialists who are well trained with over 10 years of experience in treating and managing head and neck problems. We provide minimally invasive advanced thyroidectomy surgery for full recovery with minimal post-surgery complications.

If you have any thyroid issues and want treatment, you can book a free consultation with our ENT doctors in a clinic near you and if you select Pristyn Care for your treatment, you can avail other benefits such as free cab rides, no cost EMI payment option, insurance support, etc.

Thyroidectomy surgery procedure begins with a thorough diagnosis to ensure successful surgery with a quick recovery. Diagnostic procedures performed before a thyroidectomy are:-

• Physical examination: Your ENT specialist will collect your entire medical and family history and assess the state of your thyroid problems. They will also examine your thyroid gland for any abnormalities. If there are any abnormalities, then they will prescribe the appropriate imaging and diagnostic tests for you.
• Blood tests: Blood tests are performed to measure the thyroxine (T4 hormone) and thyroid-stimulating hormones in the blood to help determine the presence of thyroid issues.
• Thyroid activity tests: There are several imaging tests like thyroid scan, radioiodine uptake test, thyroid ultrasound, etc., that help determine the level of activity of the thyroid gland and whether there are any cysts, nodules, or tumors on the gland.
• Tissue biopsy: If there is suspicious growth on the thyroid gland, a biopsy may be performed to extract tissue from the thyroid gland to determine if the patient has metastatic thyroid cancer.

Thyroidectomy is a major surgery and is generally performed under general anesthesia. Before the surgery, the surgeon will perform extensive diagnostic and imaging tests to determine how much of the thyroid tissue is to be removed.

If you are on blood thinners or similar medicines, then you need to stop those at least a couple of days before as that can increase the risk of complications. 

Since the surgery is performed under general anesthesia, you cannot eat anything after midnight on the day of the surgery. You should also arrange for someone to take you home after the surgery.

After the surgery, the patient will have a drain in the neck. This drain is usually removed the morning after the surgery. Patients are discharged within 1-2 days of the surgery. The patient may have neck stiffness with a hoarse/weak voice temporarily after the surgery due to nerve irritation but that usually resolves on its own within a few days. 

You can go back to work within 5-6 days but you should wait at least 10-14 days before performing any vigorous activities. In the case of endoscopic and traditional surgery, there will be a small surgical scar on the neck that may take at least 8-10 months to fade.

The main long-term concern following a thyroidectomy (and parathyroidectomy) is hypocalcemia. If there is any preserved thyroid tissue, eventually, the thyroid levels can return to normal. However, in the case of total thyroidectomy, a patient will have to regularly take thyroid replacement hormones.

Thyroidectomy may be recommended if the patient can’t tolerate anti-thyroid drugs or if they are pregnant. The amount of thyroid gland to be removed depends on the cause and severity of the thyroid disorder. The most common indications for thyroidectomy are:

• Thyroid cancer
• Noncancerous enlargement of the thyroid gland (goiter)
• Overactive thyroid gland (hyperthyroidism)
• The appearance of suspicious nodules on the thyroid gland 

The primary benefit of endoscopic thyroidectomy is that it is minimally invasive and hence, results in very little surgical trauma to the tissues surrounding the thyroid gland. It is a safe and precise operation in which only the affected part of the thyroid gland is removed and the rest can be easily preserved.

Since the surgery is performed through the axilla, the patient’s neck remains scar-free and even on the axilla, the scars are barely noticeable and can be easily hidden under clothes. Since there is very little surgical trauma, recovery is quick, the patient heals much faster, and the chances of postoperative complications are very low.

• Infection: Postoperative infections are rare after thyroidectomy but if they happen, they can delay healing. If there is increased pain, swelling, warmth, redness, pus drainage, or fever after the surgery, then it may be a sign of surgical infection.

• Seroma: Seromas occur due to fluid collections at the surgical site. When small, they disappear within a few weeks, but if they are large, they need to be surgically drained to prevent airway obstruction.

• Hypocalcemia (Hypoparathyroidism): Hypocalcemia, i.e.,  low blood calcium level, is a common side effect of thyroid/parathyroid gland removal. 

To manage this, patients have to take calcium supplements for at least one week after the surgery. At the first postoperative visit, blood calcium levels are checked and if normal, the patient can stop taking the supplements.

• Permanent hoarseness/Voice change: The recurrent laryngeal nerve is located in close proximity to the thyroid gland. If the nerves are irritated during the surgery, it can lead to temporary hoarseness, voice tiring, and weakness. It takes from a few weeks to six months to resolve. But if the nerve is damaged, then it will lead to a permanently hoarse voice.
• Airway obstruction: The patient may have breathing issues after the surgery due to compression of the trachea. It will usually resolve within the first 12-24 hours after the surgery, but if it persists, it can lead to hematoma formation and further health problems.

Once your surgery has been completed, you can improve your recovery by following the given tips:

• Take care of your incision. Any infection can delay healing and lead to further complications.
• Take calcium supplements for at least a couple of weeks after the surgery.
• Consult your doctor before taking a shower or swimming.
• Apply ointments on the scar to prevent it from drying and scabbing.
• Do not lift any heavy objects or perform any strenuous tasks for a couple of weeks.
• While your surgical site is stiff, you should consume foods that are soft and easy to swallow.
• Drink plenty of water during and after meals to soften the food and prevent blockages.
• If you are undergoing total thyroidectomy, then you may need thyroid hormone replacements.

• Thyroidectomy generally has a success rate of over 90%.
• The two most common early complications of thyroid surgery are hypocalcemia (occurs in 20-30% of patients) and recurrent laryngeal nerve injury (occurs in 5-11% of patients).
• Thyroidectomy does not shorten life expectancy.
• Around 42 million people in India are currently suffering from thyroid disorders. Out of these, hypothyroidism is the most common thyroid disorder in India, affecting one in ten adults.
• Thyroidectomy is one of the safest and most effective treatments for Grave’s disease.