"THYROID SURGERY /Parathyroid operation"

You will be given general anesthesia to put you to sleep. A skin cut is made at the base of your neck and is about three to four inches long. I will keep it as short as possible and if possible, will place it in one of your normal skin crease. Using magnifying lenses, I locate the thyroid gland and associated structures and all or part of the thyroid is removed. In some cases additional surgery will involve removal of lymph nodes and other structures.

During operation for Parathyroid removal, I will locate the enlarged parathyroid gland based on your scan and remove it.

The cut is stitched closed and is then covered with dressing. The operation generally lasts from two to three hours. After surgery, you will stay in the recovery room for several hours. You will be monitored closely as you recover from the anesthesia.

After surgery you will have a liquid diet for dinner. You may have a sore throat and neck, which can be easily controlled with simple painkillers. Let the nurse know if your pain is more severe, the nurse will give you a stronger pain medicine. You may have a plastic tube coming out from the skin (drain) that works to prevent any blood collecting in your neck. You will have a dressing on your neck, which will be removed in the morning. You will have routine blood tests. You will be offered regular food the next morning. Most people are ready to go home after the drain tube comes out.

As mentioned above, let us know if you need stronger painkillers. In addition, you must let us know if you experience any of the following problems

  • Difficulty in breathing - This can be because of bleeding under the skin in your neck
  • Tingling or spasm in your fingers/hand or around your mouth – This could be due to low calcium in your blood

Everyone is different. You will most likely be tired and a bit sore for a few days. You may have pain not only from your incision, but also from muscle soreness in your neck, upper back and shoulders. This is from the positioning in the operating room during the surgery. We will give you appropriate painkillers for taking at home.

Your neck may be slightly swollen as well. You may feel like you have a lump in your throat when you swallow. This will improve after a few days but may continue for a week or so.

As with any surgical procedure, there are risks with thyroid or parathyroid surgery. In addition to general risks such as bleeding, infection e.t.c the two most important risks are

  • Injury of the nerve to the vocal cords (recurrent laryngeal nerve& external laryngeal nerve)

    In most thyroid surgery, one or both of the thyroid lobes will be removed. The surgeon must utilize proper technique to avoid injury to the nerves to the vocal cords. Failure to do so can result in an injury to the nerve and result in paralysis of one or both vocal cords. Fortunately, in skilled hands, this complication is rare (less than 1%). This risk is higher if you are having a second operation or if the cancer has spread out of thyroid gland.

    Damage of this nerve leads to a significant change in voice, which may or may not recover. Although there are procedures to improve the voice should this occur, they cannot fully replicate the your previous voice with perfection. Very rarely while having operation to remove the complete gland, both the left and the right nerve may be damaged (less than 0.001%). If this happens, you will find it difficult to breath and may need a breathing tube inserted in your windpipe through your neck.

  • Injury to the parathyroid glands

    The parathyroid glands, 4 in number, lie behind the thyroid gland. They share some common blood supply with the thyroid and are quite small (about 1 cm each). They are very active little glands, producing a hormone called Parathyroid Hormone (PTH)which together with Vitamin D regulates and maintains blood calcium at a normal level.

    Though we make an effort to identify and preserve these glands during thyroid gland removal, they can be removed along with the thyroid or their blood supply can get cut off. This can give rise to low blood calcium. When only one lobe of the thyroid is removed, there is usually no risk of this complication. But when a total thyroid gland removal is deemed necessary, this risk is increased. In most cases where the calcium level falls, it is temporary as manipulation of the parathyroid glands can result in bruising of the glands causing temporary dysfunction and the level reverts to normal within a month. However, if all four glands are damaged or inadvertently removed, you will need to take calcium and Vitamin D tablets for life to maintain blood calcium levels.

Most people will need to take 1-2 weeks off after the surgery.

You may shower the day after surgery. However, try to keep the neck area as dry as possible and pat dry after showering. The stitches will be removed in the office about a week and a half after surgery. After the stitches are removed, the most important thing you can do to improve the appearance of your scar is to protect it with sunscreen that has a sun protection factor (SPF) of 30 for an entire year and massage good quality moisturizers around it.

Depending on the amount of thyroid tissue that was removed and the reason for your surgery, you may require thyroid hormone for your life. In addition, if your Parathyroids are damaged during the surgery or if all of them are removed, you will also need calcium and Vitamin D tablets.

I will see you in 2-3 weeks and will discuss the pathology report of the removed thyroid gland. If additional treatment such as more surgery of Radio-Iodine is required, I will discuss it with yourself.

If you have thyroid cancer, I recommend life long follow-up to check for its recurrence.

CLINIC INFORMATION

Northampton General Hospital
NHS Hospital
Northampton NN1 5BD
Tel - 01604 634700
BMI Three Shires Hospital
Private Hospital
Northampton NN1 5DR
Tel - 01604 620311

CONTACT US TODAY

For private consultation please contact
Tel – 07504 818402