Thyroidectomy and Parathyroidectomy

Depending on the placement and type of your condition, your surgeon may recommend a thyroidectomy or a parathyroidectomy.

Your thyroid may necessitate removal for a number of reasons. While thyroid cancer is one of the causes for this procedure, there are other thyroid disorders that may require removal of the gland, such as:

• Hyperthyroidism
• Hyperparathyroidism
• Benign enlargement of the thyroid or a goiter

The thyroid is a butterfly shaped gland that is in the bottom of your neck, just beneath the voice box. The thyroid produces hormones that control your heart rate, body temperature and weight. Behind the thyroid there are four more glands, each the size of a pea. Together these glands make the parathyroid and it is responsible for moderating calcium levels in the body.

Depending on the type and severity of your condition, all or part of your thyroid or parathyroid might need to be removed.

Fine Needle Biopsy

Before you undergo surgery, your surgeon will need to confirm your diagnosis by obtaining a biopsy or tissue sample. Fine needle aspirations are completed in your physician’s office. The needle is very thin, so anesthesia is often not required.

During the biopsy you will lie on your back. A pillow is put underneath your shoulders so you can comfortably extend your neck. Your physician will then insert a thin needle into the base of your neck where the thyroid is located and a small sample of thyroid cells will be removed. Bleeding is generally minor and can be stopped with light pressure and a small bandage.

Though you may feel a slight sting when the needle is inserted, the biopsy is typically painless. Once complete, the tissue sample is delivered to a pathologist who will examine the cells under a microscope. If the results are abnormal, you and your physician will discuss your diagnosis and appropriate treatment options.

If the biopsy indicates that the removal of your thyroid or parathyroid is necessary, one of the two procedures below might be recommended.

Thyroid Gland Removal

The thyroid is made of two lobes. Depending on the type and severity of your condition, one or both of the lobes may be removed. There are two types of thyroid gland removal:

• Total thyroidectomy: The removal of the entire thyroid.
• Partial thyroidectomy:  The removal of one of the thyroid lobes, leaving the other intact.

Both types of thyroidectomies are performed the same way. The procedure will take place in a hospital, and you will be under a general anesthesia so that you stay asleep during the operation. The procedure to fully remove the thyroid may take up to four hours to complete. A partial thyroidectomy is often shorter.

Your surgeon will remove the thyroid through an incision in the neck. In order for blood and other fluids to properly drain from the surgical site, your surgeon may place a catheter in the wound that will be removed after one or two days.

The thyroidectomy is generally considered a safe procedure, but for safety reasons we prefer to monitor every patient one night in the hospital before they return home. Though many patients are able to walk the day after their operation, it may take three to four weeks to make a full recovery. Following a total thyroidectomy, hormonal treatment is sometimes necessary to replace the hormones that were previously produced by the thyroid.

Parathyroid Gland Removal

The parathyroid is comprised of four petite glands. It is very rare for all four glands to be removed during one operation. More often, your surgeon will remove one or two of the parathyroid glands.

During a parathyroidectomy you will be under a general anesthesia. Your surgeon will make an incision in your neck just under the Adam’s apple that is several inches long. In the course of the operation your surgeon may conduct a minor blood test to evaluate calcium levels and determine if the diseased parathyroid glands were fully removed.

The length of the procedure will vary based on our ability to determine which glands require treatment prior to the operation, but will often take between one and two hours. We ask all patients to stay in the hospital one night so that we can monitor your progress before sending you home. Many patients make a full recovery after one to three weeks.

Following parathyroid removal many patients experience subtle improvements in their quality of life, including more energy, reduced aches and pain and improved memory. After the operation, we recommend regular blood tests to check your calcium levels.