If your thyroid doesn't work properly, you may need surgery to restore its function or to have it completely removed.
How Thyroid Gland Surgery Works
During thyroid surgery, the doctor accesses the gland by making an incision or a series of incisions in the neck. Depending on the specific goals of the surgery, the doctor will choose between a few different approaches. During a conventional thyroidectomy, the surgeon makes an incision in the neck directly in front of the thyroid. During an endoscopic thyroidectomy, the surgeon makes several smaller incisions and inserts surgical instruments and a video camera to guide the procedure. During a robotic thyroidectomy, the surgeon makes makes incisions in the chest or armpit and completely avoids making any incisions in the neck.
Once your surgeon can access the thyroid, they will remove it partially or totally. If you have a lobectomy, your doctor will only remove one of the thyroid’s two lobes. If you have a subtotal thyroidectomy, your doctor will remove the entire gland but leave some thyroid tissue in your body. If you have a total thyroidectomy, your doctor will take out the thyroid and all of the thyroid tissue.
Who Is a Candidate?
Thyroid surgery is a treatment option for severe cases of hypothyroidism or hyperthyroidism. However, the most common reason to need a thyroidectomy is thyroid cancer. Some candidates have a goiter, which is a noncancerous enlargement in the thyroid that can cause difficulty breathing.
Most candidates for thyroid surgery have tried taking thyroid medications without success. Some people are allergic or resistant to thyroid drugs, so the surgery is the only option. Like all surgeries, thyroidectomy has its risks, so doctors want their patients to be in the best physical condition possible before surgery. Candidates should be nonsmokers or should be able to quit smoking a few weeks before the operation, and they shouldn’t have any other physical conditions that could cause complications.
What to Expect
Your doctor will give you instructions for how to prepare for the surgery. You’ll be under general anesthesia during the operation, so you’ll have to stop eating and drinking the night before surgery. You may have to stop taking certain medications, too.
When it’s time for your surgery, a nurse will insert an IV, and an anesthesiologist will inject a sedative and administer anesthesia. Thyroid surgery usually lasts a few hours. When you wake up, your doctors and nurses will check your vitals and may give you pain medication. You’ll probably have to stay in the hospital for at least a day after the procedure.
After a day or two, you can go back to most of your normal daily activities. You’ll have to wait before exercising or engaging in other strenuous activities, though. Most people have a sore throat for a few days after the surgery, but this will go away. If you have your entire thyroid removed, your doctor will probably prescribe a thyroid hormone replacement medication.