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General Surgery

Total Thyroidectomy (Ch 8)

Built from Atlas of Thyroid Surgery

What’s inside

6 sections · 56 slides

  1. 01

    Overview

    • Scope of this chapter

    1 slide

  2. 02

    Overview and indications

    What the operation is, why open surgery remains standard, and how patients are prepared

    • What total thyroidectomy is
    • Why open surgery remains standard
    • Tools that support the operation
    • Before the operation

    4 slides

  3. 03

    Positioning and landmarks

    The patient, the case, and how the neck is set up for exposure

    • The patient and the plan
    • Positioning and landmarks
    • Patient preparation
    • Anatomical landmarks

    4 slides

  4. 04

    Left lobectomy step by step

    Incision, exposure, then freeing the diseased left lobe

    • Operative sequence at a glance
    • Skin incision and exposure
    • Skin incision
    • Incision and subcutaneous exposure
    • In-depth dissection
    • Subplatysmal flaps and strap muscles
    • Superior subplatysmal flap
    • Inferior subplatysmal flap
    • Automatic retractor and midline exposure
    • Strap muscle midline incision
    • Approaching the diseased lobe
    • Mobilization of strap muscles
    • Carotid sheath exposure
    • Initial vagus nerve functional evaluation (V1)
    • Superior pole and the EBSLN
    • Inter-cricothyroid space dissection
    • Initial EBSLN functional evaluation (S1)
    • Control of the superior vascular pedicle
    • Upper pole lateral dissection
    • Parathyroid glands
    • Identification and preservation of the superior parathyroid gland
    • Recurrent laryngeal nerve (RLN)
    • Identification of the recurrent laryngeal nerve
    • Functional assessment of RLN
    • Identification and preservation of the inferior parathyroid gland
    • Inferior pole dissection
    • Completing the left lobectomy
    • Thyroid isthmus transection
    • Division of tracheal attachments
    • Lobectomy
    • Specimen assessment
    • Specimen and post-lobectomy check
    • Postlobectomy surgical field assessment

    33 slides

  5. 05

    Contralateral lobe and closure

    Removing the opposite lobe, closing the neck, and recovery

    • Contralateral (right) lobectomy
    • Contralateral lobectomy
    • Nerve checks across the procedure
    • Strap muscle approximation
    • Closing the neck
    • Platysma muscle closure
    • Subcutaneous layer closure
    • Skin closure

    8 slides

  6. 06

    Postoperative course and references

    Day-after blood tests, key takeaways, and sources

    • Postoperative course
    • 9.0 mg/dL
    • Key takeaways
    • References
    • References
    • Atlas of Thyroid Surgery

    6 slides