Thyroid Surgery

Patient information

What is the Thyroid Gland?

The thyroid gland is a small organ that sits in the front of the neck wrapped around the windpipe (trachea). It consists of two halves (left and right thyroid lobes) joined in the middle by a thin bridge called the isthmus. The normal shape of the thyroid gland resembles a butterfly. The thyroid gland makes thyroid hormones (called T3 and T4) that affect the body’s metabolism and are essential for the body to function normally.

Why might a patient need thyroid surgery?

There are a range of reasons why I might recommend thyroid surgery for your condition. The most common reasons are to treat an overactive thyroid problem (hyperthyroidism), goitre (enlarged thyroid gland), a concerning thyroid nodule or confirmed thyroid cancer.

What type of operation should I expect?

I will explain which operation you are advised to consider and why.

  • Hemithyroidectomy. This is removal of one thyroid lobe and the thyroid isthmus. Depending on the reasons for this operation it may be necessary to have the other side of the thyroid gland removed at a second operation.
  • Total thyroidectomy. This is removal of the entire thyroid gland leaving no thyroid tissue behind. Sometimes, to protect important structures that run very close to the thyroid gland, I may leave a very tiny amount of thyroid tissue behind. This is called a near total thyroidectomy. The amount of thyroid tissue left behind is so small that for practical purposes the whole of the gland has been removed.

When is lymph node surgery needed?

Lymph nodes drain tissue fluid (or lymph) that is produced by many tissues in the body. Sometimes the lymph nodes in the middle of the neck around the thyroid gland are removed as part of an operation for patients with confirmed thyroid cancer. If cancer is found in the lymph nodes this can affect the type of treatment you might receive after surgery. When these lymph nodes close to the thyroid gland are removed the operation is called a central neck dissection. If you need a central neck dissection it does not usually affect the size of the scar. In rare cases it may be necessary to remove lymph glands from the side of the neck. This is a much larger operation resulting in a longer scar and is called a lateral neck dissection. If you need this type of surgery I will explain it to you in detail and discuss why it is necessary in your case. It is important to note that not all patients with a diagnosis of thyroid cancer will need lymph node surgery. This decision will be based on a number of factors and I will discuss the reasons for my recommendation with you.

What can I expect after the operation?

Most people stay only one night in hospital after thyroid surgery. I will give you a separate information sheet before you go home with instructions about wound care and answers to other common questions. Most patients find that they are tired for about a week after surgery but that the pain is well controlled with the simple painkillers we prescribe. Typically you will be ready to return to work about two weeks after surgery. Before you return to driving you need to be able to turn your neck freely. Be sure to let your vehicle insurance company know that you have had surgery.

What are the possible complications of thyroid surgery?

Complications from this kind of surgery are rare but I will try to ensure that the risks are fully explained to you.

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