OR / Prep · Otolaryngology, Head & Neck · open
You’re scrubbing into
Total thyroidectomy
Why are we operating?
Removing the thyroid while sparing the four glands and two nerves hiding against it: an operation defined by the structures it must not touch.
Indication: Thyroid cancer, compressive goitre, refractory thyrotoxicosis.
The operation in 4 steps
01Access
02Mobilisation and vessel control
03The recurrent nerve and the parathyroids
04Haemostasis and closure
Danger zones
Recurrent laryngeal nerve
The nerve is thread-thin, variable, and lies exactly where the gland's blood supply is ligated; traction, diathermy heat and blind clamping in a bloody field are its enemies.
Watch it done
Minimally invasive total thyroidectomy
The operation through a small collar incision, with the nerve and the parathyroids preserved.
Source: Columbia University Department of Surgery · Watch on YouTubeRisks and complications of thyroid surgery
Voice change, low calcium and bleeding: what is consented for and why.
Source: UCLA Endocrine Center, UCLA Health · Watch on YouTube
Conceptual teaching for learners preparing to observe and assist under supervision, not operative instructions. Five minutes from now you should know why this operation exists, what its shape is, and which structures it is designed not to injure.