Thyroid Gland Conditions & Services
- Thyroid Gland Removal
- Thyroid Function Tests
- Thyroid Cancer:
- Papillary Thyroid Cancer
- Follicular Thyroid Cancer
- Hurthle Cell Thyroid Cancer
- Medullary Thyroid Cancer
- Anaplastic Thyroid Cancer
- Thyroid Nodules
- Hyperthyroidism/Graves Disease
- Hashimoto's Thyroiditis
Types of Thyroid Surgery
Thyroid lobectomy (aka hemi-thyroidectomy): removal of half of the thyroid
A thyroid lobectomy may be recommended for a variety of conditions, such as a toxic nodule, goiter, an enlarging thyroid nodule, or a benign nodule that is large enough to cause symptoms, such as difficulty swallowing, shortness of breath, or hoarseness. A thyroid lobectomy may also be done because the pre-operative fine needle aspiration biopsy may be suspicious for cancer or non-diagnostic. During the operation, the surgeon may send a frozen section biopsy of the questionable nodule for pathology review. The pathologist will look at one or two sections of the thyroid nodule specimen in question while the patient is still in the operating room to see if is cancer present. If there is a clear-cut cancer, the surgeon will remove the whole thyroid instead of performing a thyroid lobectomy. Since the pathologist is only able to look at a couple of slices of the nodule at that time, a diagnosis may not be able to be made while the patient is still in the operating room. In this case, it is necessary to wait until the final pathology is ready in 5 to 10 business days after surgery. All patients that have one half of their thyroid removed will routinely need to have their thyroid level checked after surgery. Depending on these levels, thyroid hormone replacement may need to be taken.
Total thyroidectomy: removal of the entire thyroid
This operation involves removing all of the thyroid gland or nearly all of the thyroid gland in which a small piece of thyroid tissue is left behind. Thyroid tissue may intentionally be left behind usually in the area of the parathyroid glands and recurrent laryngeal nerve in order to avoid damaging these structures. A total thyroidectomy may be done for cancer, but also benign thyroid conditions that affect both lobes, such as Graves' disease, multinodular goiter, and substernal goiter, among others. After a total thyroidectomy, patients will need to take thyroid hormone replacement pills (one pill a day for the rest of their lives).
Completion thyroidectomy: removal of any remaining thyroid tissue
A completion thyroidectomy is usually done after a thyroid lobectomy reveals cancer in the first half of the thyroid that was previously removed by surgery. A completion thyroidectomy may also be done for a multinodular goiter or hyperthyroidism. After a completion thyroidectomy, patients will need to take thyroid hormone replacement pills (one pill a day for the rest of their lives).
Thyroid surgery is typically done with general anesthesia. You will have a breathing tube in place during the surgery, which is removed after surgery prior to you waking up. The surgeon will also use a recurrent laryngeal nerve monitor during surgery to assist in identifying the recurrent laryngeal nerve, to assist in the control of manipulation of the nerve during surgery, and to verify the integrity of the nerve prior to surgery closure. A total thyroidectomy can take 3 to 4 hours to complete and a completion thyroidectomy or thyroid lobectomy will usually completed in less time.
The University of Maryland Medical Center surgeons usually use incisions measuring approximately two inches in length hidden in a natural skin crease. Once the redness fades away, the incision will not be noticeable to most people.
View information about the risks of thyroid surgery and how to prepare for surgery.
For more information, please call our office at 410-328-6187.