Total thyroidectomy

The thyroid is a butterfly-shaped gland at the base of the neck, in front of the windpipe. It produces thyroid hormones, which regulate how the body works. Total thyroidectomy means removing the whole gland: both lobes and the isthmus that joins them. The operation is performed under general anaesthesia, through a horizontal incision a few centimetres long at the base of the neck, placed in a natural skin crease where possible so that it is discreet. The surgeon removes the gland while carefully preserving the recurrent laryngeal nerves, which control the vocal cords, and the parathyroid glands, which regulate blood calcium. It is offered for a large or retrosternal goitre, multiple nodules in both lobes, poorly controlled Graves' disease, or thyroid cancer. The removed gland is always examined under the microscope. After surgery, thyroid hormone replacement, taken as one tablet a day, is needed for life; it is simple and well tolerated. At Clinique Pasteur Tunis, thyroidectomy is carried out in liaison with the endocrinologist, who prepares the patient for surgery and then adjusts the hormone treatment. Blood calcium levels are monitored after the operation.