What Is Thyroid (Goiter) Surgery?
The surgical removal of all or part of your thyroid gland is called “thyroidectomy.” Thyroidectomy is used for treatment purposes in conditions such as thyroid cancer, suspicion of cancer, thyroid enlargement (goiter) without cancer, or excessive hormone secretion (hyperthyroidism).
The removal of a part of the thyroid gland is called partial thyroidectomy, and the removal of all of it is called total thyroidectomy. Which surgery will be chosen is determined according to the cause, extent, and stage of the disease, the patient’s general health status, and the patient’s preference. In partial thyroidectomy, there may not be a need for thyroid hormone use after surgery. However, in procedures where the entire gland is removed, thyroid hormone support is given after surgery.
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What Are the Possible Risks of Thyroid (Goiter) Surgery?
Thyroidectomies are generally safe procedures. However, as with any surgery, there are expected, procedure-specific undesired risks.
- Bleeding
- Infection
- Surgical damage to or removal of the parathyroid glands. As a result, numbness, tingling, or muscle cramps in the body due to low blood calcium levels.
- Airway obstruction. It may be seen due to early-stage bleeding.
- Nerve damage. Permanent or temporary hoarseness or voice weakness as a result of damage to the nerve that stimulates the vocal cords.
Thyroid (Goiter) Surgery Types
Many different methods have been described for removing the thyroid gland. Which method will be applied is determined according to the disease, the stage of the disease, the surgeon’s experience, and the patient’s preference. In all approaches, it can ensure the complete removal of all or part of the thyroid gland. Especially in endoscopic or robotic methods, concerns that sufficient tissue will not be removed or that the surgery will be incomplete are unfounded.
Conventional (Open) Thyroidectomy
This approach involves making an incision on the front part of the neck to access your thyroid gland directly. It is still the most commonly performed method in the world. There will be a surgical scar on the neck, even if minimal. The surgery is generally performed under general anesthesia and takes between 1 and 2 hours.
Endoscopic (Closed) Thyroidectomy
It is a thyroidectomy method performed using endoscopic systems. The first described methods were again those performed with a small incision made on the front part of the neck and endoscopic systems. Later, because it was not desired to have a surgery-related scar in the neck area, methods for removing the thyroid gland from sites away from the neck were developed. The best known are the armpit (axillary), armpit and nipple (BABA), behind the ear (retroauricular), and the most recently described methods from inside the lip. In almost all of them, the thyroid gland can be removed completely or partially. The most recently described scarless thyroid surgery (TOETVA) from inside the lip is distinguished from other methods because it is completely scarless.
Robotic Thyroidectomy
These are surgeries performed from sites similar to endoscopic thyroidectomy, but using robotic systems instead of endoscopic systems. Instead of endoscopic instruments, the surgery is performed with robotic arms. It has not become very widespread due to its high cost and being available in limited centers.
