Endoscopic Thyroidectomy (Scarless)

Thyroidectomy is used to remove thyroid glands affected by abnormalities like Thyroid Nodule (Cyst) , Goitre , Tumor and Multinodular Goitre (MNG) .


Among the first in India to perform scarless thyroidectomy


2 hours :
00 mins

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Thyroid gland tumor

Thyroids are small butterfly shaped glands at the base of the neck. It produces a vital hormones, including T3 and T4. Thyroid controls the metabolic rate in the body.

Thyroid glands are sensitive structure. Several things can affect the thyroid glands, starting from nutritional deficiency, to environmental pollution.

Here are some common diseases that affect the thyroid glands:

  • Connector.

    Thyroid Nodule

    …is a lump within the thyroid gland.

  • Connector.

    Goitre

    …is a condition which leads to abnormal enlargement of thyroid gland.

  • Connector.

    Tumor

    …is a condition in which abnormal uncontrollable division of cells of thyroid gland occurs (often, because of cancer).

  • Connector.

    Multinodular Goitre (MNG)

    …is a condition in which the enlarged thyroid appears with a number of separate lumps in the gland.

Understanding Thyroidectomy

There is no reliable way to normalize an overactive thyroid gland or to cure a cancerous thyroid gland. When thyroid glands start to grow, only reliable way to deal with them is to have them removed.

Given that the thyroid glands are just underneath the surface, it must be a simple procedure to have the faulty thyroid glands taken out. But for two hitches:

  • Several sensitive organs sit very close to the thyroid glands. You will need a skilled surgeon to do this surgery

There is a definite cosmetic advantage of performing a thyroidectomy in a scarless way.

  • Slashing the neck to reach the thyroid glands leave an ugly scar in a highly visible portion of the body. A minimal access procedure called endoscopic thyroidectomy avoids visible scars.
  • In a different approach, 3 small incisions are made in the armpit. Therefore, it is very unlike that the scars will be noticed by anybody.

How is Endoscopic Thyroidectomy Performed?

Total thyroidectomy

1 to 3 small incisions are made over the armpit, each cut being less than 10-12mm. Through these cuts, an endoscope (thin tube with a camera, light and surgical instruments) is inserted. With the help of the endoscope, the surgeon locates the thyroid gland and removes it. Of course, care must be taken to avoid injury to the muscles, nerves, blood vessels and adjoining organs.

This procedure leaves only a small scar, that too underneath the armpit. Hence, for all practical purpose, it is scarless.

treatment window

The main reason to remove the thyroid gland is because an enlarged thyroid gland can convert into a cancer any time. As it is just supplementation with Thyroxine tablets would replace the function of the gland. Hence it is better to get it removed whenever there is even a little suspicion of cancer.

Life after Endoscopic Thyroidectomy

  • Proper care of wound should be taken by keeping it clean and healthy.
  • The medicines like thyroid hormone supplements, vitamin d and calcium should not be skipped.
  • The level of thyroid hormones in the blood should be checked at a regular interval.

Endoscopic Thyroidectomy FAQ’s

I know, many people feel it’s a gimmick. But having performed nearly a 100 of these, and completely successful, and having sent it off for publication in surgical journals, I can tell you that endoscopic thyroidectomy or keyhole thyroidectomy is a reality.

The reason is that the training to perform endoscopic thyroidectomy is not widespread and consequently most surgeons do not know how to perform endoscopic thyroidectomy. In those centers were it is being performed regularly, however, it is definitely the procedure of choice.

A regular thyroidectomy involves a slash incision on the neck. Here we access the thyroid through three small holes in the armpit, and these are completely invisible. We have recently started removing thyroids through the mouth as well by the so-called trans-oral thyroidectomy. And these two are completely invisible because it only involves two or three small stitches within the mouth, which heal up by themselves.

It requires a few specialized instruments and laparoscopic team with tremendous experience and co ordination. If this is done, then this operation can be well performed and it will be a complete success.

Yes, it does take twice or thrice as long as regular open thyroidectomy, but with the increasing experience there will be definitely a decreasing time and it should only take a little longer than conventional open thyroidectomy in experienced units. Our average time for one-sided endoscopic thyroidectomy is about 90 minutes compared to 45 minutes for an open thyroidectomy. Considering that the scars are invisible, the increased time for the surgery should not really be a major consideration.

It is not at all more expensive than the regular thyroidectomy, apart from a slightly increased theater cost.

Yes we have now started doing total thyroidectomies endoscopically for cancer of the thyroid as well. This has completely revolutionized the management of cancer of the thyroid.

Actually the nerve injury is much less in endoscopic thyroidectomy as compared to open thyroidectomy because one actually attacks the thyroid from both sides and this is were the nerves are running. Therefore we are able to see the nerves and preserve them better in endoscopic thyroidectomy, compared to open thyroidectomy.

Endoscopic Thyroidectomy Specialists

Dr. J. S. Rajkumar

CHIEF SURGEON

M.S., F.I.C.S., Dip. N.B. (SURG.), F.R.C.S. (ENG.), F.R.C.S. (EDIN.), F.R.C.S. (GLASGOW), F.R.C.S. (IRELAND), F.I.M.S., F.A.I.S., F.R.M.S. (LONDON), F.A.E. (GASTRO), F.A.C.G. (USA), F.I.C.A. (USA), F.I.A.G.E.S., Dip M.I.S. (FR.)


Dr. C.M.K. Reddy

M.B.B.S., DSc., F.R.C.S. (GLAS), F.R.C.S., F.R.S.H (Eng), F.I.C.S, F.I.C.A (USA)

CONSULTANT SURGEON AND VASCULAR SURGEON.