The Surgical Procedure

The Surgical Procedure

In the surgery, the surgeon will cut a 3- to 5-inch incision across the base of your neck in front. The skin and muscle are pulled back to expose the thyroid gland. The incision is usually made so that it falls in the fold of the skin in your neck, making it less noticeable.

Blood supply to the gland is "tied off," and the parathyroid glands are identified (so that they can be protected). The surgeon then separates the trachea from the thyroid, and removes all or part of the gland.

A newer technique, known as endoscopic thyroid surgery, involves using a small magnifying camera inserted in the neck. Carbon dioxide gas is pumped into the neck area to help make it easier to see and work on the gland. A second small incision is made, and a thin tube with a scalpel-like edge is inserted through that incision. This tube is the surgical tool that is used to remove the thyroid. Endoscopic surgery, because it involves two small scars of less than one inch, usually leaves less visible scarring, and allows a quicker return to normal activity. Sometimes, the entry point is under the arm -- known as axillary surgery.

Endoscopic surgery is not common, however, and you'll need to investigate to find a surgeon with experience doing these surgeries.

Most surgeons use dissolvable stitches, but you may want to ask your surgeon ahead of time which kind he plans to use, because the non-absorbable stitches actually tend to cause less scarring. If you have any history of allergic skin reactions to past stitches, you may also want to ask your doctor about using hypoallergenic suture material.

After the surgery, you will usually remain under observation at the hospital for at least 6 hours. If you are having outpatient surgery, you may be discharged after that point.

Before you are discharged, your incision is usually covered with a clear protective waterproof glue called colloidium. (This allows you to bathe or shower after the surgery.)

Rarely, if there is concern about bleeding or if the thyroid is very large and the surgery has left a large open space, a drain will be left in your wound to prevent fluid from accumulating. You'll need to return to the surgeon a few days later to have the drain removed.

After Your Surgery

Thyroid surgery is generally considered extremely safe. There are some common short-term side effects after thyroid surgery such as pain when swallowing, and neck stiffness. Most patients also become hypothyroid after surgery and require thyroid hormone replacement therapy. These issues are discussed in greater depth in the article on Recuperating After Thyroid Surgery .

While complications are not common, a few can result from thyroid surgery. These include hypoparathyroidism and hypocalcemia, and laryngeal nerve damage. Signs can include numbness and tingling around your lips, hands, and the bottom of your feet, muscle cramps and spasms, bad headaches, anxiety, depression, hoarseness, and difficulty speaking loudly. You can read more about it in Complications After Thyroid Surgery.