Thyroid surgery

Specialty of Surgery

What is thyroid surgery?

Thyroid surgery removes all, or part, of the thyroid gland. It is also known as a ‘thyroidectomy’. This operation can be used to treat thyroid cancer, hyperthyroidism (excess of thyroid hormone), and thyroid nodules.

Why is thyroid surgery performed?

The thyroid gland, located in the neck, produces thyroid hormone, which controls the body’s metabolism. Thyroid surgery may be performed for different reasons, but the most common is the growth of tumours or nodules (usually non-cancerous lumps) on the thyroid. Surgery can also correct hyperthyroidism, a condition in which too much thyroid hormone is produced.

Thyroid surgery may also be performed as a treatment method for goitre, which refers to swelling or enlargement of the thyroid gland. Goitres can be large enough to block the throat, which affects the patient’s ability to swallow and breathe, among other things.

What does it involve?

The type of surgery offered will depend on the patient and how suitable they are – there are various types of procedure and the surgeon will advise which is best. The most common types of procedure include lobectomy, total thyroidectomy, and subtotal thyroidectomy.

In a lobectomy, one of the two lobes in the thyroid gland is removed. This is performed in patients where swelling, cancers, or nodules only affect half of the thyroid gland.

In a subtotal thyroidectomy, the thyroid is removed, but a little thyroid tissue is left behind. This means the function of the thyroid gland remains intact. However, this can cause hypothyroidism (where not enough thyroid hormone is produced).

In a total thyroidectomy, the entire thyroid gland is removed along with the tissue. This surgery is usually indicated in cases where nodules or swelling affect the whole thyroid gland, or in cancer patients.

During surgery, an incision is made in the neck to remove the thyroid gland, or part of it. The procedure is performed under general anaesthetic, meaning the patient is not conscious throughout. Thyroid surgery can also be performed as a minimally invasive procedure.

How can you prepare for thyroid surgery?

An initial consultation must be made before the surgery is scheduled, to check if the patient is a candidate for thyroid surgery. The surgeon will advise any precautions which need to be taken, and will explain what is safe to take regarding medications, if the patient has any prescribed. Blood thinners must not be taken for several days before surgery (e.g ibuprofen, aspirin). The surgeon can answer questions the patient may have about the procedure during the consultation.

Post-operative care

Thyroid surgery is generally successful and complications are infrequent. After the surgery, a few days off work is expected, and driving should not be considered until the patient can turn their head from side to side, and is no longer taking medication for pain relief. After the operation, discomfort is normal, and the patient may feel that they have a sore throat for a few days afterwards.

Patients should expect a scar to form, which over the months following the operation will gradually fade until it is barely noticeable.

In some cases, hypothyroidism is a side effect of surgery. Hypothyroidism can be managed with hormone replacement, and patients can expect to live a normal, healthy life. 

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