Thyroidectomy

Thyroidectomy is the removal of all or part of your thyroid gland. Your thyroid is a butterfly-shaped gland located at the base of your neck. It produces hormones that regulate every aspect of your metabolism, from your heart rate to how quickly you burn calories.

Your surgeon may do the procedure through a surgical cut in your neck.

Your surgeon will make a 3-inch to 4-inch cut in the middle of your neck, right on top of the thyroid gland. Then the surgeon will remove all or part of the gland.
The surgery can also be done using a smaller surgical cut that is less than 2 inches long.
Your surgeon will be very careful not to damage the blood vessels and nerves in your neck.
Your surgeon may place a small tube (catheter) into the area to help drain blood and other fluids that build up. The drain will be removed in 1 or 2 days.
Surgery to remove your whole thyroid may take up to 4 hours. It may take less time if only part of the thyroid is removed.

There are three main types of thyroid surgery:

Total Thyroidectomy — Complete Removal of the Thyroid
This is the most common type of thyroid surgery, and is often used for thyroid cancer, and in particular, aggressive cancers, such as medullary or anaplastic thyroid cancer. It is also used for goiter and Graves’/hyperthyroidism treatment.

Subtotal/Partial Thyroidectomy — Removal of Half of the Thyroid Gland
For this operation, cancer must be small and non-aggressive — follicular or papillary — and contained to one side of the gland. When a subtotal or partial thyroidectomy is performed, typically, surgeons perform a bilateral subtotal thyroidectomy which leaves from 1 to 5 grams on each side/lobe of the thyroid. A Harley Dunhill procedure is also popular, in which there’s a total lobectomy on one side, and a subtotal on the other, leaving 4 to 5 grams of thyroid tissue remaining.

Thyroid Lobectomy — Removal of Only About a Quarter of the Gland
This is less commonly used for thyroid cancer, as the cancerous cells must be small and non-aggressive.
The issue of a subtotal/partial, vs. total thyroidectomy is controversial. Some practitioners prefer to perform a partial thyroidectomy whenever possible, believing that they will leave behind enough thyroid tissue to prevent hypothyroidism. (A total thyroidectomy has nearly a 100 percent chance of causing hypothyroidism). The risk of hypothyroidism with subtotal thyroidectomy is, however, quite high, and some experts say that more than 70 percent of patients receiving a subtotal thyroidectomy will become hypothyroid. Since one of the main reasons for subtotal thyroidectomy is to prevent hypothyroidism, and that goal is achieved in only a minority of cases, experts increasingly believe that there is no added benefit to subtotal thyroidectomy, and are more routinely recommending a total thyroidectomy.

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