Thyroi: Dectomy

THYROIDECTOMY
OVERVIEW
Thyroidectomy
- is an operation that involves the surgical removal of all or
part of the thyroid gland.
- is traditionally a minimally invasive surgery performed
through a small horizontal incision in the front of the neck.
There are 3 types of surgical removal of all or part of

Thyroid Gland
1.Thyroid Lobectomy
2.Subtotal Thyroidectomy
3.Total Thyroidectomy
- surgery usually takes 2 to 3 hours.
INDICATIONS
1 Diagnosis of Thyroid Cancer
2 Graves disease or Hyperthyroidism
3 Large goiters or thyroid nodules
4 Multi-nodular Goiter
4
SURGICAL PREPARATION
POST-
PREOPERATIVE INTRAOPERATIVE OPERATIVE
PHASE PHASE PHASE
A. PREOPERATIVE PHASE
● Informed Consent- The surgeon is responsible for obtaining the
consent and explaining the procedure and the nurse will ensure
that the consent form has been completed and placed in the clients
medical records.
● Complete medical history and physical exam- including patient’s
surgical and anesthesia background, medication the patient have
taken before the expected date of surgery, allergic reactions and
history of smoking/drinking alcohol.
● Pre-operative client teaching-inform the patient what to expect
During and after surgery, how to manage pain (demonstrations of
non invasive pain relief techniques, the DBCT techniques.
● Pre-operative vital signs- to establish baseline data with whicih to
compare alteration that occur during and after the surgery.
B. INTRAOPERATIVE PHASE
● The S.O. will be shown to the waiting area While the patient will be
taken inside the Operating room.
● A member of the operating room team will help you onto the
operating bed.
● The patient should be placed in a supine position with the apex of
the patient’a head at the top of the operating bed.
● A shoulder roll or gel pad should be placed at the level of the
acromion process of the scapula to help extend the neck.
● Compression boots will be placed on your lower legs. These gently
inflate and deflate to help blood flow in your legs.
● Once you’re comfortable, your anesthesiologist will give you
anesthesia through your IV line and you will fall asleep. You will also
get fluids through your IV line during and after your surgery.
C. POST-OPERATIVE PHASE
Transferring the patient from Post-
Anesthesia Care Unit (PACU) to recovery
room. The nurse will be monitoring the
patient’s vital signs, oxygen levels, airway
patency and neurologic status; managing
pain; assessing the surgical site; assessing and
maintainig fluid and electrolyte balance; and
providing a thorough reports of the patient’s
status to the receiving nurse on the unit, as
well as the patient’s family or significant
others.
• fine needle aspiration biopsy (FNA)
• electrocardiogram (EKG) • thyroid ultrasound, and a fine-
to check your heart needle aspiration should be
rhythm performed for large or suspicious
• a chest x-ray nodules
• b l o o d t e s t s / a n a l y s i s - • CT Scan- help to determine the
determines the levels of size of the thyroid gland and
active thyroid hormones location of abnormalities.
circulating in the body. • nuclear medicine scan- used to
• a cardiac tress test assess thyroid function or to
• carotid doppler study evaluate the condition of a thyroid
nodule, but it is not considered a
routine test
Laboratory test performed before surgery
§ Do
u b l e-
h o o k s p r o n g ed
handle s ki n
§ #3 knife § Ma
h
e § B o o r n er r et r
Surgical instruments
§ #15 blad
t is s u e forceps v ie e a cto
§ A d s o n
hout h a r m l ec t r o c a u t r
with and wit on
a n d / o i c s c a l p el y ,
er
t eet h r Sh ,
o l a r e a w sca l p e
§ Bip
forceps
§ D eB a k ey f o r c ep l ec t r o l
needed
osquito s c a u t er y
§ Halsted m § If i
nt ra o
forceps n eu r a p er a t i v e
s w a n n ec k l
R e in h o ff t o be m o n i t o r i n
rlisher
§
g
clamp (or Bu p
n er v e er f o r m ed , i s
clamp) m o ni
L ea d s to
forceps a nd s ri ng
§ Allis tissue el ec t r u
ic h a r d s o n r et r a c t o r o d e p r fa c e
R en d o t ri
r a c h e m ed
§
ittner
§ P ea n u t / K § N er v e a l tub
s p o n g es St i m u e
la tor
Video for
Thyroidectomy
Procedure
Click Here to view the

video:
https://www.youtube.com/w
atch?v=2tCajgpPcGo
There is only minimal to moderate
T
postoperative pain after thyroidectomy. In
EN
the immediate postoperative period this
EM
can be managed with small boluses of
AG intravenous opioids followed by oral opioids
AN
and acetaminophen when the patient is

capable of oral intake. The patient may put
M
a cold compress on his surgical cut for 15

IN
minutes at a time to ease pain and swelling.

PA
DO NOT put the ice directly on the skin.

Wrap the compress or ice in a towel to
prevent cold injury to the skin. Keep the
area dry.
POSSIBLE COMPLICATIONS
A, Hypocalcemia secondary to hypoparathyroidism
- You may have temporary parathyroid dysfunction
after your surgery. This means that your parathyroid
glands may not make enough hormone to maintain the
level of calcium in your blood. While this is temporary, it
can cause hypocalcemia. It is when you don’t have
enough calcium in your blood.
- symptoms includes numbness and tingling of the digits
or perioral area, carpopedal spasm, or the presence of a
Chvostek sign or a Trousseau sign. Call your doctor if you
have any of these symptoms.
B.Recurrent laryngeal nerve
injury- This nerve controls your
vocal cords and if injured you will
have a hoarse voice. Patients may
occasionally experience hoarseness
or vocal fatigue.
C.Neck hematoma- A rare
but dangerous complication of
thyroidectomy, neck
hematomas can form secondary
to inadequate hemostasis or a
coagulopathy. Incidence of this
complication is approximately
1%, but its occurrence can lead
to asphyxiation and airway
compromise.
D.Infection- The usual presentation is a
superficial cellulitis with warmth, erythema, and
tenderness surrounding the surgical incision. If
fluctuance is present, a superficial abscess may
also be present. Other signs of infection, such as
fever and leukocytosis, without an overlying
cellulitis, may point to a deep space neck
infection or abscess.
E.Bleeding: There is a 1/300 risk of
bleeding with your operation. This is the main
reason you stay overnight in the hospital.
F.Thyrotoxic storm- One of the rarer
complications from thyroid surgery is precipitation of
a thyroid storm, which can occur intraoperatively or
postoperatively. It is thought to occur secondary to
thyroid gland manipulation in the operating room in
patients with hyperthyroidism. Manifestations include
tachycardia, hyperthermia, cardiac arrhythmias, and
increased sympathetic output. Awake patients also
present with nausea and altered mental status. If
untreated, it may precipitate coma and death.
DISCHARGE PLANNING
Wound Care
Follow instructions on Your Diet During Recovery
how to care for your You can eat whatever you like after
incision.If the incision surgery. Try to eat healthy foods. You may
was covered with skin
find it hard to swallow at first. If so, it may
glue or surgical ta p e
strips, you may shower be easier to drink liquids and eat soft foods
with soap the day after such as pudding, Jello, mashed potatoes,
surgery. Pat the area apple sauce, or yogurt.
dry. The tape will fall Pain medicines can cause constipation.
off after a few weeks. Eating high-fiber foods and drinking plenty
If your incision was of fluids will help make your stools softer. If
closed with stitches, ask
this does not help, try using a fiber product.
your surgeon when you
can shower. You can buy this at a drug store.
Activity
Give yourself time to heal. DO NOT do any
strenuous activities, such as heavy lifting, jogging,
or swimming for the first few weeks.
Slowly start your normal activities when you
feel ready. DO NOT drive if you are taking
narcotic pain medicines.
Cover your incision with clothing or very
strong sunscreen when you are in the sun for the
first year after surgery. This will make your scar
show less.
Thyroid Hormone Replacement
You may need to take thyroid hormone
medicine for the rest of your life to replace your
natural thyroid hormone. Depending on the
Doctors reccomendation
You may not need hormone replacement if
only part of your thyroid was removed.
See your doctor for regular blood tests and to
go over your symptoms. Your doctor will change
the dosage of your hormone medicine based on
your blood tests and symptoms.
Follow-up
You will probably see your surgeon in
about 2 weeks after surgery. If you have
stitches or a drain, your surgeon will
remove them.
You may need long-term care from an
endocrinologist. This is a doctor who
treats problems with glands and
hormones.
When to Call the Doctor
Call your surgeon or nurse if you have:
Increased soreness or Chest pain or discomfort

pain around your incision
Redness or swelling of A weak voice

your incision
Bleeding from your incision Difficulty eating
A lot of coughing and

Fever of 100.5°F (38°C),
Numbness or tingling in your
or higher
face or lips
THANK YOU
Submitted by:
Thalia Millena Minuza
Jake Nerio

Thyroi: Dectomy

Uploaded by

Copyright:

Available Formats

Thyroi: Dectomy

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Thyroi: Dectomy

Uploaded by

Copyright:

Available Formats

THYROIDECTOMY

There are 3 types of surgical removal of all or part of

1 Diagnosis of Thyroid Cancer

3 Large goiters or thyroid nodules

Click Here to view the

and acetaminophen when the patient is

a cold compress on his surgical cut for 15

minutes at a time to ease pain and swelling.

DO NOT put the ice directly on the skin.

Increased soreness or Chest pain or discomfort

Redness or swelling of A weak voice

Bleeding from your incision Difficulty eating

A lot of coughing and

You might also like