Thyroidectomy (Lobectomy / Total)

Procedure Snapshot

• Indication: Thyroid nodules, malignancy, Graves’.
• Expected duration: ___
• Special instruments: Nerve monitor, Ligasure, harmonic scalpel.

Step Workflow

1. Transverse cervical incision; raise flaps.
2. Identify midline raphe; divide strap muscles.
3. Identify and preserve RLN and parathyroids.
4. Ligate superior and inferior thyroid vessels.
5. Remove lobe(s); hemostasis.

Key Pimp Questions

• Q: RLN course? In tracheoesophageal groove.
• Q: Post-op hypocalcemia cause? Hypoparathyroidism.

Critical Anatomy

• Landmarks: RLN, superior laryngeal nerve, parathyroids.
• Danger zones: RLN, EBSLN.

Informed Consent Highlights

• Hoarseness, hypocalcemia, hematoma.

Post-op Considerations

• Ca monitoring ×48 h; voice check.

References

• Chassin’s, Endocrine. Clinical Scenarios, Thyroid.
• Bergenfelz 2019 (PMID 31051264).