Thyroid surgical procedures begin with the insertion of an endotracheal tube, followed by the administration of general anesthesia. Once the anesthesia takes effect, the procedure begins with an incision 2 inches to 4 inches long that stretches horizontally over the thyroid. Based on the tests performed before the procedure and the appearance of the thyroid, the final determination of how much of the thyroid should be removed is made.
At this point, the portion or portions of the thyroid are removed using a scalpel. Special care is taken not to harm or disturb the parathyroid glands and the vocal cords, both of which rest in the neck near the thyroid.
A biopsy may also be done to examine the tissues of the thyroid, the parathyroid and, in rare cases, nearby lymph nodes. This is done to make sure that the portion of the thyroid that is left, if any, is not diseased. In some cases, the tissue is examined by a pathologist immediately, so that a second surgery to remove a diseased portion of the thyroid is not necessary.
Once the thyroid has been removed and any necessary samples have been taken, the area is examined for bleeding. Once the surgeon is confident that there is no bleeding present, the incision is closed. It may be closed with staples or sutures, and in some cases, a surgical drain may be placed to remove fluid from the area in the days after surgery.
Once a sterile bandage is applied to the incision, the surgery is completed. Anesthesia is discontinued and medication is given to wake the patient. The patient is then taken to the recovery room to be closely monitored while the remaining anesthetic wears off.