Thyroid Surgery

Surgery Overview

Thyroid surgery takes out part or all of your thyroid gland. The gland makes hormones that control how your body makes and uses energy (metabolism).

A doctor may take out part or all of the gland when it gets too big, doesn't work right, or has a growth. Most growths or lumps in this gland are benign. This means they aren't cancer.

This surgery may be needed for problems such as thyroid nodules, thyroid cancer, and hyperthyroidism.

During your surgery, your doctor may take out a lump or nodule. A doctor will look at the tissue under a microscope.

• If the sample gives a clear answer for your problem, your doctor may leave the rest of your thyroid. Or you may have all of it removed.
• If the answer isn't clear, your doctor may leave the thyroid. More tests may be done on the tissue. When the test results come back, you may need surgery to take out the rest of your thyroid.

The doctor will take out the tissue, lump, or tumor through a cut (incision) in the front of your neck. You will likely have a tube, called a drain, in your neck. It lets fluid out of the cut. The drain is most often taken out before you go home.

You may go home on the same day. Or you may stay one or more nights in the hospital after surgery. You may return to work or your normal routine in 1 to 2 weeks. This depends on whether you need more treatment and how you feel. It may also depend on the kind of work you do.

Your doctor will check your incision in about a week. You may need to take thyroid medicine. If you have thyroid cancer, you may need to have radioactive iodine therapy. Your doctor will talk to you about what happens next.

Types of surgery

Types of thyroid surgery include:

Total thyroidectomy.

Your surgeon will remove the entire gland and the lymph nodes surrounding the gland. Both sections (lobes) of the thyroid gland are usually removed. If you have thyroid cancer, other treatments with thyroid-stimulating hormone (TSH) suppression and radioactive iodine work best when as much of the thyroid is removed as possible.

Thyroid lobectomy with or without an isthmectomy.

If your thyroid nodules are located in one lobe, your surgeon will remove only that lobe (lobectomy). With an isthmectomy, the narrow band of tissue (isthmus) that connects the two lobes also is removed. After the surgery, your nodule will be examined under a microscope to see if there are any cancer cells. If there are cancer cells, your surgeon may perform a complete thyroidectomy.

Subtotal (near-total) thyroidectomy.

Your surgeon will remove one complete lobe, the isthmus, and part of the other lobe. This is used for hyperthyroidism caused by Graves' disease.