Thyroidectomy surgery or Thyroidectomy is a surgical procedure to remove all or part of the thyroidal gland. Usually, thyroid surgery is carried out due to the presence of nodules or tumours in the thyroid gland. Most tumours are benign, but some can be cancerous or precancerous.
Thyroidectomy is performed if benign nodules grow big enough to obstruct the throat or stimulate the thyroid to overproduce hormones (Hyperthyroidism). Also, if the swelling or enlargement of the thyroid glands causes Goitre which obstructs the throat effecting the ability to speak, eat and breathe.
The amount of thyroid gland removed depends on reason of surgery. There are three types of thyroidectomy:
- Lobectomy – when there is a nodule that is inflamed, or swollen in only half of the gland, only one of the two lobes are removed with the remaining lobe retaining its normal function.
- Partial thyroidectomy – only a part is removed due to hypothyroidism (when the thyroid does not produce enough hormones) and the remaining thyroid is able to function normally again after surgery.
- Total thyroidectomy – entire removal of the thyroid due to cancer or the entire gland is swollen or inflamed which needs a daily treatment to replace the function of the natural thyroid through hormone replacement.
The thyroid is a butterfly shaped gland that is located just below the voice box, at the base of the neck. Small as it may be, it controls the hormone production regulating our metabolism, heart rate and the speed of calories burnt.
Indications of Thyroidectomy
- Thyroid Cancer – the most common reason for thyroidectomy, either partial or entire thyroidectomy is carried out.
- Overactive Thyroid (Hyperthyroidism) – when the hormone thyroxine is overproduced, Hyperthyroidism occurs. Thyroidectomy may be resorted to if you have a reaction to anti-thyroid drugs and preferred not to have radioactive iodine therapy.
- Noncancerous enlargement of the thyroid (Goitre) – if the Goitre is large enough that it affects your eating, breathing, speaking and discomfort or it causes Hyperthyroidism.
Diagnosis and Tests
- Physical examination of the neck region
- Blood tests
- CT Scan
Types of Thyroidectomy Surgery
- Conventional Thyroidectomy – an incision in the centre of the neck to connect directly to the thyroid gland.
- Endoscopic Thyroidectomy – making smaller incisions on the neck, the surgeon uses surgical instruments and a camera inserted inside to guide through the procedure.
- Robotic Thyroidectomy – to avoid incision in the centre of the neck, this approach makes incisions through the armpit and chest or an incision high in the neck.
- Your doctor will physically examine the affected region.
- Get diagnostic tests suggested by your doctor.
- Inform you doctor of your medical history and current medications if any along with allergies.
- Your doctor will discuss the best option for you after all needful are done.
- If you have Hyperthyroidism, you may be given some medications like potassium and iodine solution to regulate your thyroid function and decrease the risk of bleeding.
- You may be asked to stop certain medications if you have been taking them like blood thinners, herbal supplements etc.
- You will be asked to fast 8 – 12 hours before surgery.
- Make sure you do not wear any jewellery, make-up, or contact lenses during operation.
- Medications given before surgery should be taken with small sips of water.
- You will be given general anaesthesia, then fall into a deep sleep and feel no pain.
- Your blood pressure and heart rate will be monitored during the surgery.
- It takes about 2 or more hours to perform this surgery.
- The surgeon makes a small incision or a few of them on the neck depending on the reason of surgery.
- The surgeon then removes all or part of the thyroid gland.
- Your lymph nodes around the thyroid are also examined and removed if necessary.
- The incisions are closed and dressing applied.
- A drain may be kept under the incision in your neck and may be taken off a day after.
- You may experience neck pain, temporary sore throat or hoarse voice and pain medication may be administered as needed.
- You may stay in the hospital for a night or more depending on your recovery.
- You will be given instruction on self-care and follow up.
- You will be able to resume normal activities after 10 days without stressing yourself too much.
- If there is partial thyroidectomy, you may be given thyroid hormone replacement medicine.
- If an entire thyroidectomy is done, you may need to take thyroid hormones for replacement for the rest of your life.
- If you developed Hypothyroidism, your doctor will give you medications to balance your hormone levels.
Risks and Complications
Though Thyroidectomy is a safe surgery, as with any procedure, it is not without risks. Certain complications that could occur are:
- Hypoparathyroidism due to damage of four glands leading to low calcium levels and increased amount of phosphorous in the blood stream
- Permanent hoarse or weak voice due to never damage
- Obstruction of airway due to bleeding
Factors affecting the cost of Thyroidectomy Surgery
The cost of Thyroidectomy surgery starts from US $1800. However, price may vary depending on factors like:
- Location of the hospital
- Choice of hospital
- Cost of diagnostic tests
- Surgeon’s fee
- Medical treatment
- Duration of hospital stay