Thyroid surgery is used to treat patients who have a nodule or nodules, an enlargement or overactivity of this gland. The following are causes of thyroid nodules:
- Multinodular goiter (MNG)
- Hashimoto thyroiditis
- Thyroid cyst
- Follicular adenom
- Subacute thyroiditis
- Papillary carcinoma
- Follicular carcinoma
- Hürthle cell carcinoma
- Medullary carcinoma
- Anaplastic carcinoma
- Primary thyroid lymphoma
Minimally Invasive Thyroid Surgery
Minimally invasive open thyroidectomy (MIT) is similar to conventional thyroidectomy in its surgical approach. The major difference is the length of the neck incision. A smaller incision improves cosmesis and reduces discomfort. Typically, a skin incision less than 6 cm is considered minimally invasive. The remainder of the procedure is exactly the same as is used in conventional thyroidectomy. Adaptations to this technique include transection rather than lateral retraction of the strap muscles.
Minimally invasive video-assisted thyroidectomy (MIVAT) typically involves a skin incision no greater than 3 cm that is placed slightly higher than the conventional thyroidectomy incision. Open dissection is carried out until the superior thyroid pole is encountered, after which the endoscopic video-assisted techniques are used.
Parathyroid glands control the amount of calcium in our blood and bones. About 1 in 700 people (1 in 250 women over 50) develop a parathyroid gland tumor causing parathyroid disease, called: “hyperparathyroidism”. Hyperparathyroidism is a destructive disease that causes high blood calcium–which leads to serious health problems–even early death. It can be cured in most patients in less than 20 minutes with parathyroid tumor removal.
Minimally Invasive Parathyroid Surgery
The overproducing parathyroid gland is made radioactive so it can be differentiated from the other structures in the neck. By using the Sestamibi scan, only the parathyroid tumor becomes radioactive. Now that the surgeon knows what general area to operate upon, the surgeon makes a small incision and only operates in a small area of the neck. A miniature hand-held radiation probe is inserted into the incision to find the radioactive parathyroid. Then the surgeon dissects where there is greatest probe activity in the area of the overactive parathyroid tumor. Once the tumor is removed, the surgeon measures the radioactivity in the parathyroid to make sure that all of the radioactive tumor has been removed. The surgeon will then determine whether more operating is necessary. Finally, the neck is bandaged and the patient is ready to go home. Because the MIRP operation is performed quickly and with limited dissection, patients can usually leave the hospital the same day. Overall pain is minimal, and the bandage is left in place for about a week.