The thyroid is part of the endocrine system and functions to produce thyroid hormone, which regulates metabolism. The gland is located in the midline of the neck over the trachea (windpipe). There is a right lobe, left lobe, and isthmus (center component).
Removal of the gland is indicated for three main reasons:
- A total thyroidectomy is performed to remove the entire thyroid gland. A thyroid lobectomy is the removal of either the left or the right thyroid lobe. It is most commonly removed due to a nodule(s) in the gland that is either discovered because a “lump” is palpable to the patient or doctor, or it is noted on imaging like ultrasound or a CT scan. If the thyroid nodule(s) are suspicious for cancer, they thyroid lobe or entire gland is removed.
- Secondly, the thyroid may have multiple nodules on one or both lobes. Thyroid removal is indicated if this “goiter” is large enough to cause compression of the esophagus or trachea, which may cause difficulty swallowing or breathing troubles.
- Finally, thyroidectomy is occasionally necessary to remove a hyper-functioning gland that is overproducing thyroid hormone (i.e. Grave’s Disease).
Thyroid surgery is performed under general anesthesia. A thyroidectomy is perfomed through an incision in the lower part of the neck in the midline. The size of the incision varies depending upon the size of the nodules and the extent of surgery, but is usually only 3 to 4 cm in length and typically heals with only a faint scar. Occasionally a drain is placed in the wound if the surgeon is concerned about post-operative bleeding. The drain is usually removed 1-2 days after surgery. Overnight hospitalization is required when a total thyroidectomy is performed in order to monitor calcium levels (see Risks section). When a thyroid lobectomy is performed, the length of the hospital stay varies depending upon travel distance and surgeon discretion. Pain levels vary, but patients often have mild to moderate pain and discomfort for 3 to 7 days.