Surgery of the thyroid gland

Area of Science:

• Endocrinology
• Surgical Oncology
• Otolaryngology

Background:

• Total thyroid lobectomy is a common surgical procedure.
• Minimizing morbidity and preserving nerve and gland function are critical surgical goals.

Purpose of the Study:

• To describe a surgical technique for total thyroid lobectomy that prioritizes safety and functional preservation.
• To outline methods for identifying and preserving the recurrent laryngeal nerve and parathyroid glands.
• To detail strategies for parathyroid gland reimplantation when necessary.

Main Methods:

• The surgical technique begins with identifying the recurrent laryngeal nerve at the inferior thyroid pole.
• Superior pole vessels are ligated last, carefully avoiding the external branch of the superior laryngeal nerve.
• Parathyroid glands are identified, preserved, and can be reimplanted into strap muscle, sternocleidomastoid muscle, skin incision, or forearm skin.

Main Results:

• The described surgical approach allows for total thyroid lobectomy with minimal morbidity.
• The recurrent laryngeal nerve and parathyroid glands can be effectively identified and preserved.
• Parathyroid autotransplantation is feasible using various implantation sites, with muscle implantation avoided in cases of carcinoma.

Conclusions:

• Total thyroid lobectomy is a feasible and safe procedure when employing this meticulous surgical technique.
• The described method facilitates preservation of vital structures, leading to reduced patient morbidity.
• Effective parathyroid gland management, including reimplantation, is achievable, though site selection depends on the underlying diagnosis.