A hemithyroidectomy is a surgical procedure that removes one lobe of the thyroid gland.
This type of operation is advisable to carry out in the early stages of the development of benign and malignant processes, but only if they are localized within the boundaries of one lobe.
During the operation, not only the lobe is removed, but also the isthmus – the part that connects the affected lobe with the healthy one. Modern medical professionals use endoscopic hemithyroidectomy. This is the most sparing minimally invasive technique, which provides for low injuries and quick recovery.
Indications for hemithyroidectomy are neoplasms, primary malignant tumors, calcification of thyroid nodes, the formation of several nodes, chronic thyroiditis, and large nodular tumors.
Preparing for an operation
Before the operation, it is important to prepare for it in advance. First of all, you need to undergo a study of the level of hormones and antibodies, an ultrasound examination of the thyroid gland and lymph nodes.
Also, the doctor should examine the patient’s vocal cords and give a referral for magnetic resonance imaging.
According to certain indications, the doctor may prescribe scintigraphy and genetic testing. Scintigraphy allows you to evaluate the activity of secretion of hormones. In this case, radioactive isotopes are used. Genetic testing can identify medullary carcinoma.
A biopsy is also scheduled before the operation. With its help, you can determine the qualitative composition of the tissue and suggest the causes that contributed to the development of the disease. No preparation is required for this. The procedure takes approximately 40 minutes and takes place under general anesthesia.
Course of operation
Currently, doctors make a very small skin incision. Of course, first of all, the size of the incision should provide a complete overview of the neck organs, but doctors also care about the maximum cosmetic effect.
Surgery is performed without crossing the short muscles of the neck, which reduces swelling and pain after surgery. A harmonic scalpel is used for all manipulations. With this tool, you can significantly reduce blood loss.
The surgeon makes markings on the neck, and the anesthesiologist introduces the patient into a medical sleep. The depth of the incision is approximately 3 mm, and the length is 7-8 cm.
Opened muscles are bred in a blunt way. The doctor visualizes the organ and evaluates the exact localization of pathological foci and the nature of the damage.
Next, the surgeon highlights the recurrent nerve of the larynx and all the main structures of the organ. After that, the lobe and isthmus are excised. During hemithyroidectomy, hemostasis is performed, since there are many vessels around the gland.
Therefore, it is very important that the doctor conducts a proper stop of bleeding. After the operation is completed, drainage is done and all damaged soft tissues are sutured with special medical threads, which dissolve on their own after a few months.
Complications and rehabilitation
If after the operation the patient has bleeding, the doctor performs manipulations again in order to find the source of bleeding. Also, a person may experience an allergic reaction to anesthesia or other drugs used. In this case, antihistamines are administered and resuscitation is carried out. Therefore, it is important to talk to the anesthesiologist before the operation, talk about possible allergies and conduct all the necessary studies.
One of the complications can be called nerve damage and impaired voice functions. In this case, plastic surgery of the vocal cords is performed and vitamins are prescribed.
It is worth noting that modern medicine allows you to minimize problems, but there is still a risk of their occurrence. Paresis of the larynx is corrected with medicines, a surgical method and special gymnastics. With neck stiffness, therapeutic physical culture and manual therapy are prescribed. Infections are treated with antibiotics.
After all the manipulations, the patient is transferred to the ward. Bed rest is recommended for the first 24 hours.
If drainage is installed, then remove it the next day. Patients note that after surgery, there is a sore throat, muscle tension and soreness in the wound area. Therefore, during the rehabilitation period, one should avoid heavy physical exertion, refuse to visit saunas and baths, replace sugar with honey and try not to overwork.
The recovery process will be faster if you follow all the doctor’s recommendations and take prescribed medications.
If after a hemithyroidectomy there is such a problem as cervico-shoulder syndrome, then the patient is prescribed manual therapy. To restore the psycho-emotional state, you should visit a psychotherapist. Any physical exercises aimed at restoring the cervical region are used only after consulting an endocrinologist.