SCARLESS OR MINIMALLY INVASIVE THYROIDECTOMY
This procedure is meant to perform half or total removal of thyroid gland by a technique which causes less scar in the neck or no visible scar in the neck.
Indications: are no previous surgeries in the same area of neck with nodule or thyroid size <=5cm, larger thyroid can be removed with no visible scar but with combined approach (placing incision in the skin behind the ear and in the armpit) Technique : Retroauricular approach (FIGURE 1): incision is placed in area behind the ear and in the hairline so it is not visible, tunnel is created upto thyroid lobe which is to be removed. The skin flap is held up with Chung’s retractor. Endoscope is introduced with for magnified view, specialised instruments are used to perform thyroidectomy (half or total removal of thyroid gland). Incision on other side may be required for removal of opposite thyroid. Special care is taken during surgery for identification of recurrent laryngeal nerve (figure 2), and its preservation, so that injury to this nerve is avoided. Parathyroid glands (figure 2)which are situated on the backside of thyroid lobe ,these glands control level of calcium in the body. These glands needs to be preserved so that calcium levels are maintained in normal . By this approach we do by ROBOTIC SURGERY (DAVINCI – XI ) or by ENDOSCOPIC SURGERY. It depends on the surgical expertise of the surgeon which surgery he is going to perform. Endoscopic surgery has the advantage of same approach with much decreased cost . Admission in the hospital is for 1-2 days. Recovery time is 2weeks.