A thyroidectomy is an operation that involves the surgical removal of all or part of the thyroid gland. Surgeons often perform a thyroidectomy when a patient has thyroid cancer or some other condition of the thyroid gland (such as hyperthyroidism) or goiter. Other indications for surgery include cosmetic (very enlarged thyroid), or symptomatic obstruction
**Indication :
1\Thyroid cancer.
2\MNG.
3\Toxic thyroid nodule.
4\Grave's disease.
Steps
1) Horizontal anterior neck incision (if possible, within a skin crease).
2) Create upper and lower flaps between the platysma and strap muscles.
3) Divide vertically between the strap muscles and anterior jugular veins.
4) Separate the strap muscles from the thyroid gland.
5) Divide the middle thyroid vein.
6) Mobilize the superior pole of the thyroid lobe. Divide the superior thyroid artery and vein close to the thyroid gland (avoid injury to the external branch of the superior laryngeal nerve and the superior parathyroid gland).
7) Identify the recurrent laryngeal nerve whenever possible using the nerve monitoring device.
8) Identify the inferior parathyroid gland.
9) Divide the inferior thyroid artery and vein.
10) Separate the thyroid lobe and isthmus from the trachea.
11) Repeat this process for the other thyroid lobe. Remove the thyroid gland.
12) Reapproximate the strap muscles & the platysma muscle.
13) Close the skin with a subcuticular stitch.
