FAQ

Frequently asked questions about thyroid surgery

Re-operative thyroid surgery

 

Q: What types of thyroid surgery are there? Is the whole thyroid always removed?

  • Thyroid lobectomy and isthmusectomy: this is when half of the thyroid (or one lobe) is removed along with the middle part of the thyroid that connects the two lobes. This surgery is generally performed for benign lesions that are causing symptoms, for a nodule with an “indeterminate” biopsy for diagnostic purposes, or for very small cancers, less than 1cm.
  • Total thyroidectomy: this is when the entire thyroid gland is removed. This surgery is performed for almost all known cancer cases, in patients with nodules in both thyroid lobes, and for Graves’ disease.

Q: What type of anesthesia will I have?

  • General anesthesia.

Q: How long does surgery take?

  • Surgery can take anywhere from one to six hours once you are asleep depending on the type of surgery you are having. 

Q: How long will I be hospitalized?

  • Most patients that undergo a total thyroidectomy will spend one night in the hospital and go home the next morning.
  • Some patients that have only a thyroid lobectomy and live locally may be able to go the same day after six hours of monitoring in the recovery area.

Q: Will surgery affect my voice or cause any other side-effects?

  • One of the rare side effects of thyroid surgery is injury to one of the recurrent laryngeal nerve that controls your voice. This complication occurs in about one to two percent of patients.
  • It is not uncommon to experience some temporary hoarseness after an extensive surgery.

Q: Do you monitor the nerves that control the voice during surgery?

  • Yes. A nerve monitor is used during your entire thyroid operation. This allows the surgeon to confirm that the recurrent laryngeal nerve (the one that controls your voice) is working at the end of the case.

Q: When will I know the findings of the surgery?

  • The results of your final pathology can take up to seven business days. The surgeon will call you with the results if they are back in a few days. Otherwise, the surgeon will discuss the results with you at your post-op appointment.

Q: Will I have a big scar?

  • While we perform minimal access surgery at Providence Saint John’s Health Center and try to minimize the size of the incision, the final determination will depend on what type of surgery you are having, the size of your neck, and the size of your thyroid gland.
  • Most patients heal very well from surgery and have minimal residual scar at six months
  • It is important to apply suntan lotion to the surgical site for up to one year after surgery to prevent darkening of any scar.

Q: Will I have stitches?

  • You will not have any stitches that need to be removed.

Q: Will I have to take medication if I still have half of my thyroid?

  • Approximately half to three-quarters of patients that have half a thyroid will not need hormone replacement. However, there are no accurate predictors of who will need medication and who will not.
  • Your thyroid function will be tested about six weeks after surgery and a determination will be made at that time.

Q: Will I have to take medication if I have no thyroid?

  • Yes. You will have to take thyroid hormone replacement for the remainder of your life. It is a small pill that you take once a day (either first thing in the morning or before bedtime) on an empty stomach.

Q: How long is recovery? When can I go back to work?

  • Everyone can eat, drink, and talk that same day right after surgery.
  • While you may feel some fatigue for two to three days (general anesthesia), you will be able to perform your normal activities.
  • Most people only take a few days off from work.
  • For more information please refer to thyroid surgery – what to expect form for more information.

Q: Will I need follow-up appointments once my thyroid gland has been removed?

  • You will be scheduled for a post-op visit 10 to 14 days after your surgery. 
  • If the final pathology is benign, you only need to follow-up with your endocrinologist or primary care provider for monitoring of your thyroid function.
  • If the final pathology is cancer, then lifelong follow-up is needed with both your endocrinologist and with the surgeon.

Re-operative thyroid surgery

Q: Do re-operative thyroid operations have more complications?

  • In general, any re-operative surgery has a greater risk of complications because you are entering an area with a lot of scar tissue and sometimes the normal anatomy looks different.
  • For thyroid surgery, there is slightly higher rate of nerve injury and hypocalcemia. You should discuss this with your surgeon

Q: Do you use any special techniques for this kind of operation?

  • All patients that are scheduled to undergo re-operative neck surgery that includes the thyroid bed will have their vocal assessed pre-operatively.
  • An ultrasound will be used in the operating room to identify and confirm the thyroid tissue and/or lymph nodes that are to be removed.
  • Sometimes, dye or a radio-labeled isotope will be used to help identify a recurrent lymph node intra-operatively that was planned for removal.

Q: Where can I find additional resources and information?