Endoscopic Thyroidectomy

Endoscopic Thyroidectomy What is the thyroid gland and what does it do?

The thyroid gland is a butterflyshaped gland in the middle of the neck located below the larynx (voice box) and above the clavicles (collarbone). A normal thyroid gland cannot be externally seen or felt.

The thyroid gland makes thyroid hormones which play a major role in the metabolism, growth and maturation of the human body.

A thyroid nodule is a round or ovalshaped lump within the thyroid.

Thyroid nodule(s) can cause a visible or obvious enlargement of the thyroid gland which is known as “goitre�.

Thyroid nodules are very common and can be caused by many different conditions. About 80-85 per cent of all thyroid nodules are caused by benign (non-cancerous) conditions.

Image source: https://openi.nlm.nih.gov/detailedresult.php?img=PMC3016122_jsls-10-2-206-g01&req=4 License: https://creativecommons.org/licenses/by-nc-nd/3.0/

What is Endoscopic Thyroidectomy?

Totally endoscopic trans-axillary thyroidectomy is the removal of one or both lobes of the thyroid gland via an incision in the armpit to avoid a neck scar. If your condition suits an endoscopic thyroidectomy, your specialist will recommend it for you. All cases will be evaluated by an ultrasound scan before surgery.

Who is suitable for this surgery?

Endoscopic Thyroidectomy might be recommended for patients with the following condition: 1. Benign singular nodules 2. Some cases of multinodular goitres 3. Some low-risk early thyroid cancers

Endoscopic Thyroidectomy is generally avoided for very large nodules and in patients with previous neck surgery and hyperthyroidism (overactive thyroid gland).

How safe is this surgery technique?

Endoscopic Thyroidectomy is a key-hole surgery and is expected to be as safe as the conventional technique of thyroidectomy where the incision is at the neck.

Patients will be asleep during the surgery under general anaesthesia.

Most patients can be expected to be discharged one day after surgery. Post-surgery consultation is usually required two to three days after discharge.

What are the risks?

Complications which are uncommon may include: • Skin bruising or subcutaneous emphysema (trapped air under the skin): 10% • Major bleeding (requiring repeat surgery): 1-2% • Conversion rate : 3-5% • Small collection of residual blood or fluid in the early postsurgery period: 1-5%.

• Temporary voice change/ Hoarseness: 1-5% - Patients who have this typically recover in a few weeks.

• Permanent voice change/ Hoarseness: < 1% - Your surgeon will advise you about the option of using Intraoperative Nerve Monitoring to reduce the risk of such injury.

• Paraesthesia/numbness over the chest: 1-5%.

- Most cases are temporary and will recover after a few weeks. Very rarely (<1%) it may be long term.

• Accidental removal of parathyroid (calcium regulating) glands: 1-5%

What to expect?

Before the surgery, your doctor may: • Do a physical exam and review your medical history • Have blood tests done • Have x-rays or other imaging tests done. All cases will be evaluated with an ultrasound scan.

• Fine needle aspiration may be performed for further investigations.

• Talk to you about any medications, herbs, and dietary supplements that you may be taking. You may be asked to stop taking some medications for up to one week before the procedure.

Contact us If you have any further queries or clarifications, you can contact our surgeon by making an appointment through our hotline 65558828.

Yishun Health is a network of medical institutions and health facilities of the National Healthcare Group.

Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.

GS.PE.28.0817