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basic info about Thyroid Surgeries
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THYROID SURGERIES
HemithroidectomySubtotal thyroidectomyNear total thyroidectomyTotal thyroidectomy
HISTORY
Pioneers in thyroid surgeriesTHEODOR KOCHERTHEODOR BILROTHWILLIAM HALSTEDCHARLES MAYOGEORGE CRILE
In 1909 Kocher received the nobel prize for medicine for his contributions to thyroid physiology,pathology & surgery.
INDICATIONS
CosmesisCompressionCancerToxicity
PREOPERATIVE INVESTIGATIONS
Basic investigations FNAC USG neck Thyroid profile X-ray neck AP,Lateral ENT opinion Investigate for other co-morbid conditions-
Diabetes,Hypertension,Heart disease,etc. Anaesthetic fitness for surgery
ANATOMY OF NECK
ANATOMY OF NECK
THYROID-ARTERIAL SUPPLY
THYROID-VENOUS DRAINAGE
RECURRENT LARYNGEAL NERVE
POSITION
Supine Neck extended Sandbag under the
shoulders Head up tilt with head
ring Both arms tucked to the
patient’s sides Skin prepared from the
level of mandible to the nipples
INCISION
Low collar skin crease incision 2 cm above the suprasternal notch
INCISION
Skin, subcutaneous tissue,platysma incised
Sub platysmal flap raised
Upper limit is thyroid cartilage
Lower limit is medial ends of clavicle
Deep fascia incised
Strap muscles separated in the midline
PLANE OF DISSECTION
FASCIAL DISSECTION
FASCIAL DISSECTION
GLAND SEPARATED FROM THE MUSCLES
GLAND SEPARATED FROM THE MUSCLES
SUPERIOR PEDICLE
SUPERIOR PEDICLE IDENTIFICATION
SUPERIOR PEDICLE LIGATION
SUPERIOR PEDICLE LIGATION
MIDDLE THYROID VEIN IDENTIFIED
MIDDLE THYROID VEIN LIGATED
INFERIOR THYROID VESSELS LIGATED
POSTERIOR CAPSULAR DISSECTION SAFEGAURDING
RECCURRENT LARYNGEAL NERVE & PARATHYROIDS
COMPLETION OF SUBTOTAL THYROIDECTOMY
CLOSURE
CLOSURE