Have you also been told to have a thyroidectomy?

A small swelling in the neck, difficulty swallowing, or thyroid cancer... Has the doctor told you about an operation to remove the thyroid gland for a reason like this? It's very normal to feel a little scared and anxious when you hear this. "Who doesn't like an operation?" you might think. But if we know exactly and simply about this surgery called ` Thyroidectomy `, that fear can be eliminated to a great extent. So, let's talk about everything about it today.

Simply put, what is thyroidectomy?

Okay, first let's look at what the thyroid gland is. The thyroid gland is a small butterfly-shaped organ located in the front of your neck, on either side of your windpipe. Although it's small, it does a lot of work. It controls many important processes in the body, such as metabolism.

Now, `Thyroidectomy` refers to the surgical removal of the thyroid gland, either completely (`Total Thyroidectomy`) or only part of it (`Partial Thyroidectomy`). Just like removing a decayed tooth, what is being done here is removing the thyroid gland or part of it that has been damaged by a certain medical condition.

Why do we need to do this operation?

"Why would you suddenly remove a perfectly healthy thyroid?" you may be wondering. There are several main reasons for this. Let's take a closer look at what those reasons are.

What are the types of thyroidectomy surgeries?

There are two main types of surgery. Your doctor will decide which type is best for you based on your condition.

• Total Thyroidectomy: This is where your thyroid gland is completely or almost completely removed. This procedure is usually used in cases of thyroid cancer or goiter that has spread throughout the gland.
• Partial Thyroidectomy: This is also called a `Hemithyroidectomy` or `Lobectomy`. The thyroid gland has two main parts (lobes). This surgery removes only one of the two parts. This method is usually used if there is a lump on only one side of the gland.

Important questions to ask the doctor before the operation

It is your right to ask all your questions before an operation, and it will help to ease your fears. Here are some questions you can ask your doctor.

• Why do I need this operation, doctor? Aren't there other treatments for my condition?
• What are the risks of this operation? What are the chances of complications?
• How much of my thyroid gland do you expect to be removed? All of it? Or just part of it?
• Will I have to take thyroid hormone pills for the rest of my life after the operation? (This is a question that many people have)
• How long will I have to stay in the hospital after the operation? How long will it take to get back to normal?

The answers to these questions will give you a better understanding of the entire process.

How do we prepare for the operation?

Like any surgery, this one requires some preparation. Your doctor will give you clear instructions about this.

A few weeks before surgery

• Tests: A thyroid ultrasound scan may be ordered to see exactly where the lump is. If there is any doubt as to whether the lump is cancerous, a fine needle aspiration (biopsy) may be performed, which involves taking a small sample of cells with a needle.
• Voice test: The function of your vocal cords , which produce your voice, can be tested.
• Medication: If your thyroid hormone levels are very high, you will be asked to start medication before the operation to control it.
• Smoking: If you are a smoker, your doctor will definitely advise you to quit, as smoking can interfere with the anesthesia and healing process.

About a week before surgery

• Tell your doctor about all the medications you take: You should tell your doctor about all the medications you take, including prescription medications, vitamins, herbal remedies, and supplements. He or she will tell you which medications you should take and which you should stop taking on the day of your surgery.
• Blood thinners: If you are taking blood thinners, you should only stop them temporarily on your doctor's advice. Never stop taking them without your doctor's advice.

Before surgery

You will need to fast (abstain from food and drinks other than water) for a few hours before the operation. You will receive clear instructions from the hospital about this.

What happens during the operation?

You don't have to think about this too much, because you're sound asleep.

Before the surgery, an anesthesiologist will put you under anesthesia and put you completely to sleep . So you won't feel any pain. To make it easier to breathe during the surgery, a breathing tube will be placed down your throat.

There are several ways for the surgeon to reach the thyroid gland:

• Traditional method: The surgery is performed through a small incision in the crease of the neck. This is done to minimize scarring.
• Mini-incisional angioplasty (MIVAT): This surgery is performed through a very small incision with the help of a camera.
• Scarless methods: There are now methods of performing surgery by making incisions in places where scars are not visible, such as inside the mouth and under the armpits.
• Very rarely: If the gallbladder has gone all the way into the chest, it may also have to be done through the breastbone.

If the surgery is for cancer, the surgeon will take a sample of the lymph nodes around the thyroid gland and examine them. If the cancer is found to have spread there, those lymph nodes may also be removed.

At the end of the surgery, dissolvable stitches are placed inside and a special type of glue is applied over the skin.

Surgery to remove the entire thyroid gland usually takes between 1-3 hours. Surgery to remove only part of the gland takes less time.

What are the risks of this operation?

First of all, a thyroidectomy is a very safe surgery in most cases . Complications are rare. However, like any surgery, there are some risks.

• Excessive bleeding: This is very rare, but if it does happen, a blood clot can block the airway and cause difficulty breathing.
• Damage to the vocal cords: The nerves that control the voice pass very close to the thyroid gland. If these nerves are damaged during surgery, a hoarse voice or weakness may occur. This is often temporary. Surgeons are very careful to identify these nerves and avoid damaging them.
• Damage to the parathyroid glands: Attached to the back of the thyroid gland, there are four small glands about the size of four grains of rice. These are called parathyroid glands. They control the calcium levels in the body. If these are damaged during surgery, the calcium levels in the blood can drop (hypocalcemia) .

These risk factors are more likely to occur if you have advanced cancer, if this is your second thyroid surgery, or if you have a very large goiter.

How long does it take to fully recover?

You will stay in the hospital for one or two days. Once you are fully awake from the anesthesia, you will be able to eat light meals and drink fluids. You may have a slight sore throat for a few days due to the breathing tube that was placed during the surgery.

Before you go home, you will receive instructions on how to care for your incision.

Usually, you will feel completely better in two to three weeks . However, you should wait at least two weeks before you can resume activities like exercising and lifting weights.

About the scar

Yes, a small scar will be left on the front of the neck. This can be anywhere from 1-2.5 inches in size. However, the doctor will make this incision in a crease in the skin of the neck, so it will become less noticeable over time. The scar may take 12-18 months to heal completely. Initially, it may be red and slightly raised, but over time, it will fade to a lighter color and become flush with the skin. Follow your doctor's instructions to help your scar heal quickly.

If you have these symptoms, see a doctor immediately.

After returning home, it is important to act immediately if any problems arise. Be on the lookout for the following symptoms.

Facing any surgery is not easy. It is normal to have fears and doubts. However, a thyroidectomy is a safe procedure that is performed regularly and has very successful results. Most people recover very well after the surgery, especially if the surgery was to remove cancerous cells, and there is a great sense of relief. If you still have concerns, don't be afraid to talk to your doctor. They are there to help you.