Hemithyroidectomy (lobectomy and isthmusectomy)

Hemithyroidectomy, or lobectomy with isthmusectomy, means removing only one of the two lobes of the thyroid together with the isthmus, the central part joining the two lobes. The other lobe is kept. It is offered when the disease affects only one side of the gland: a single large or troublesome nodule, a nodule whose needle biopsy is inconclusive, a nodule that produces too much hormone (toxic nodule), or some small low-risk cancers. Microscopic examination of the removed lobe gives a definitive diagnosis. The operation is performed under general anaesthesia through a small horizontal incision at the base of the neck. As with total thyroidectomy, the surgeon identifies and preserves the recurrent laryngeal nerve and the parathyroid glands on the operated side. The parathyroids on the other side are not touched, which makes calcium problems very rare. The remaining lobe is often enough to produce sufficient hormones: hormone treatment is then not needed, but a blood test is done a few weeks after surgery. At Clinique Pasteur Tunis, this operation is carried out in liaison with the endocrinologist, who provides follow-up.