Total Thyroidectomy

What is a total thyroidectomy?

Thyroid Surgery Hobart Endocrine Surgeon General Surgeon DR Jessica Preece.

Thyroid Surgery Hobart Endocrine Surgeon General Surgeon DR Jessica Preece.

The thyroid gland is located in the neck and is responsible for producing hormones that regulate the body's metabolism. The lobes of the thyroid gland are connected by a small bridge of thyroid tissue called the isthmus. A total thyroidectomy is removal of the entire thyroid gland.

Why might I need a total thyroidectomy?

There are several reasons why someone might need a total thyroidectomy including:

  • Multinodular goitre: A multinodular goiter is a condition in which there are multiple nodules on the thyroid gland. A total thyroidectomy may be necessary to remove the nodules.

  • Graves' disease: An autoimmune disorder that causes the thyroid gland to overproduce hormones.

  • Toxic multinodular goitre: A condition in which one or more nodules on the thyroid gland become overactive and produce excess hormones.

  • Thyroid cancer: If a person has been diagnosed with thyroid cancer, a total thyroidectomy may be recommended to remove all of the cancerous cells. 

Further Information about total thyroidectomy

What does total thyroidectomy surgery involve?

  • General anaesthetic

  • Incision in a skin crease at the front of the neck

  • All sutures are dissolvable under the skin

  • Waterproof dressing so you can shower after the operation

  • Removal of the entire thyroid gland including the isthmus and pyramidal lobe

  • Identification and preservation of the recurrent laryngeal nerves which are the nerve supplying the vocal cords

  • Identification and preservation of the parathyroid glands with transplantation into the nearby sternocleidomastoid muscle if they cannot be adequately preserved

  • Sometimes a small drain tube is inserted and is usually removed within 24hrs

  • There are no dietary restrictions post operatively

  • You can mobilise as soon as you have recovered from the anaesthetic

  • Usually an overnight stay in hospital

  • The thyroid tissue that is removed is sent away for examination by an anatomical pathologist with results usually being available at your follow up appointment

  • You will be commenced on calcium tablets from the evening of surgery and have a blood test the morning after surgery to check you parathyroid hormone and calcium levels

  • You commence thyroxine medication (synthetic thyroid hormone) the morning after surgery. A blood test will be performed 6 weeks after your surgery and a dose adjustment may be required

How long is the recovery after total thyroidectomy?

  • Overnight stay in hospital

  • Thyroidectomy is not a particularly painful operation, local anaesthetic will be used at the time of surgery which will last for up to 24hrs. Simple analgesia such as paracetamol and ibuprofen is usually all that is required

  • The skin is healed in 10-14 days

  • You can resume driving when you are comfortable to make an emergency stop and head turn without causing discomfort. You should check with your individual insurance provider for specific policy details

  • Avoid strenuous exercise for 4 weeks post operatively

  • A blood test will be performed the morning after surgery to check your parathyroid and calcium levels.

  • Thyroid function will be checked at 6 weeks post operatively

What are the risks of total thyroidectomy surgery?

It's important to note that a total thyroidectomy is a major surgery and carries risks such including:

  • Bleeding

  • Scar

  • Infection

  • Hypocalcaemia

  • Voice change

  • Lifelong thyroxine

  • Deep vein thrombosis/ pulmonary embolus

The decision to have a total thyroidectomy is typically made after careful consideration and discussion with Dr Preece.