When Is Thyroid Surgery Recommended?

• Suspicious or confirmed thyroid cancer
• Large goitre causing airway compression, difficulty swallowing, or cosmetic concerns
• Functioning nodules causing hyperthyroidism not controlled by medical therapy
• Rapidly growing nodules or symptomatic cysts
• Multinodular disease with recurrent symptoms

Types of Thyroid Surgery

1. Hemithyroidectomy / Lobectomy

Removal of one thyroid lobe (± isthmus). Often sufficient for a single suspicious nodule or unilateral benign disease.

2. Total Thyroidectomy

Removal of the entire thyroid gland. Recommended for confirmed cancer, large bilateral disease, or some cases of hyperthyroidism.

3. Completion Thyroidectomy

Removal of remaining thyroid tissue after an earlier lobectomy when further treatment is required.

4. Subtotal Thyroidectomy

Partial removal leaving a small remnant; less commonly performed today due to recurrence risk.

5. Central / Lateral Neck Dissection

Removal of lymph nodes in the central or lateral neck compartments when cancer has spread to nodes.

Surgical Approaches & Techniques

• Conventional open thyroidectomy through a small low-neck incision
• Minimally invasive and remote-access approaches (endoscopic, robotic) for select patients seeking minimal scarring
• Intraoperative nerve monitoring to help identify and protect the recurrent laryngeal nerve
• Hemostatic techniques and careful dissection to reduce bleeding and complications

Preoperative Evaluation

A thorough evaluation ensures safe surgery and appropriate planning.

• Clinical examination of the neck and vocal cord function
• Thyroid ultrasound and ultrasound-guided fine-needle aspiration (FNAC) of nodules when indicated
• Thyroid function tests (TSH, free T4) and other blood work as needed
• CT/MRI for large retrosternal goitres or invasive disease
• Anesthesia assessment and discussion of risks, benefits, and need for lifelong thyroid hormone replacement if total thyroidectomy performed

How Thyroid Surgery Is Performed

Thyroidectomy is usually performed under general anesthesia and may be day-care or require overnight admission depending on the extent of surgery and comorbidities.

• A small transverse incision is placed in a natural neck crease for best cosmetic outcome
• Meticulous dissection to identify and preserve the recurrent laryngeal nerves and parathyroid glands
• Removal of diseased thyroid tissue with secure hemostasis
• Drains are rarely needed; wound closed with fine sutures to minimize scarring

Risks & Possible Complications

• Bleeding or hematoma — may rarely require urgent re-exploration
• Temporary or permanent injury to the recurrent laryngeal nerve causing hoarseness
• Hypocalcaemia from temporary or permanent parathyroid dysfunction (manifesting as tingling or muscle cramps)
• Wound infection, seroma, or poor scar (uncommon)
• Need for lifelong thyroid hormone replacement after total thyroidectomy

Recovery & Aftercare

• Most patients resume light activities within a few days; avoid heavy lifting for 1–2 weeks
• Sutures removed or absorbable sutures are used; scar care instructions provided
• Monitor for tingling, numbness (signs of low calcium) — supplements given if required
• Voice rest if advised; ENT review and possible voice assessment if hoarseness persists
• Thyroid hormone replacement initiated and adjusted based on blood tests when total thyroidectomy performed

Benefits of Surgery

• Definitive treatment for cancer and many nodular diseases
• Relief of compressive symptoms (breathing, swallowing)
• Control of hyperthyroidism in selected cases
• Improved cosmetic appearance for large goitres

Why Choose Dr. Shrekha Padmakshan?

Dr. Shrekha Padmakshan offers specialised thyroid and endocrine surgery with emphasis on oncologic safety, nerve and parathyroid preservation, and excellent cosmetic outcomes.

• Experience in complex thyroid and neck dissections
• Use of intraoperative nerve monitoring and advanced hemostatic techniques
• Multidisciplinary care with endocrinologists, pathologists and anaesthesiologists
• Personalised follow-up for hormonal replacement and long-term surveillance

If you have thyroid nodules, an enlarging goitre, abnormal biopsy results, or symptoms of compression or hyperthyroidism, book a consultation for a detailed evaluation and surgical plan tailored to your needs.