By Dr. Padmanabh R Bhat, General Surgery,
The thyroid gland is a small, butterfly shaped gland located just below the larynx. This gland is responsible for the secretion of hormones and plays a large role in regulating the body’s metabolism and internal temperature. Sometimes, in case of cancerous nodules, hyperthyroidism etc. a doctor may advise thyroid surgery to partially or completely remove the thyroid gland. Surgery may also be required in cases of goitre. This surgery is known as a thyroidectomy.
A thyroidectomy is performed while the patient is under general anaesthesia and can take up to four hours. In rare cases, it may also be performed while the patient is under local anaesthesia. It is important for the patient not to eat or drink anything from the midnight before surgery onwards. Once the patient is asleep, the surgeon will make a 3 to 4 inch horizontal incision just above the thyroid gland. Part of the gland or the whole gland will then be removed through this incision. A catheter is usually placed in the vacated area to ensure blood and other fluids are drained out and not allowed to accumulate. The cut is then sutured shut and allowed to heal. The rain is generally removed 2 to 3 days after the surgery.
Surgeons today are also starting to perform this procedure endoscopically so that a smaller incision is required. In most cases, the patient is hospitalised overnight and discharged the next day. In rare cases, hospitalisation may extend up to three days. It is essential that the patient can swallow liquids before he or she is discharged. Though the patient can move about the day after the surgery itself, complete recovery can take between 3 to 4 weeks. During this time, the patient may experience pain which may be treated with over the counter pain medication. Strenuous exercising and heavy lifting should be avoided for ten days after the surgery.
Depending on how much of the thyroid gland is to be removed, the patient will need to take thyroid hormone replacement medication on a long term basis. This is usually needed in the case of a total thyroidectomy. Some patients may also need calcium supplements.
Thyroid surgery is generally considered a safe surgery, but as with any other type of surgery, there are a few risks associated with this procedure. These include:
- Allergic reactions to anaesthesia
- Breathing problems
- Blood clots
- Damage to the vocal cords or larynx
- Change in voice
- Temporary increase in thyroid hormone levels
- Injury to the glands around the thyroid gland
- Temporary hypocalcemia