Thyroidectomy: My Experience
- atikshchandra
- Jul 23, 2022
- 3 min read
What is a Thyroidectomy?
Thyroidectomy is the surgical removal of the thyroid gland located in the front of the neck. Essentially, the thyroid is a butterfly-shaped gland that secretes hormones that control metabolism processes such as heart rate and calorie burning. Thyroid cancer, thyroid nodules, and other conditions may require the need for a thyroidectomy. The patient will then have to take supplemental hormones to keep bodily functions.
The Process
I started shadowing the surgery early with one main general surgeon and two residents. The first step was opening the skin. The skin was pulled back and clamped to open up the neck region. Next, the muscle on top of the gland was carefully cut and moved to the side. The surgeon proceeded to cut around the thyroid gland and parathyroid glands carefully before snipping off the bottom. Finally, the surgical area of the neck closed by suturing the top muscle and then the skin.
The thyroid gland is very vascular as it is located in the neck. Because of this, there tend to be lots of bleeding with every incision as there are numerous blood vessels. In this case, the patient's thyroid gland was swollen on the left side pressing into the trachea. The gland further pressed against the esophagus making it hard to eat and breathe. Cancer was the likely reason for this sort of swelling.
Heavy bleeding ensued because of the highly vascularized area of the neck. Every section must be carefully cut and clotted as you continue. To clot the blood, a method known as cauterization was utilized. Essentially, a two-pronged forceps with an electrical charge passing through it burns the flesh wherever it is pressed down. Utilizing this method, the surgeon can stop the bleeding and proceed with a clear view of the thyroid gland being careful not to create too much blood loss.
The general surgeon was teaching his residents about this procedure. I watched the resident stay calm even with complications. The resident was having trouble differentiating between the tissue of the thyroid and the surrounding muscle. It is important not to cut the thyroid so you can remove it effectively. He asked the general surgeon for advice throughout and was guided by his words.
My thoughts
This surgery was significantly harder to watch for a couple of reasons. For one, the surgery was performed on the neck and it felt quite unnatural to cut in such a sensitive area. Another reason was the sheer amount of blood. As I said previously, the vascularity of the region led to more blood loss than in the previous surgeries I had watched. Furthermore, the fact that a resident surgeon was experimenting led to more conflict in conversation with the doctor.
In this surgery, there was also a heart rate monitor attached to the patient to ensure their stability during the procedure. I never knew how loud that machine was until hearing that sound for hours on end. In this procedure, along with many others, the sound has reverberated throughout the OR. Unfortunately, I wasn't able to get a picture of the thyroid gland after removal, but it was the size of a large marble or a foosball when circulated.
Watching the surgical residents talking with the surgeon was also quite interesting. Nearly every action by the resident was either scrutinized or complimented by the doctor. At first, I found this quite taxing but I realized the necessity of such demanding feedback on the value of the resident's knowledge of the procedure. It was also interesting to watch the nurses and surgical tech help with the procedure and guide the resident based on their knowledge of surgery.
Here are some pictures I took:
This is the actual surgical site and the clamp pulling back the skin on the patient's neck. You can get a feel for the vascularity of the region just by the redness of the picture
This isn't a great surgical picture, but I wanted to include it to show the cauterization forceps and surgical instruments used while performing surgery.
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