How is thyroid surgery

Thyroid surgery

The aim of a thyroid operation is to remove all of the diseased thyroid tissue and to protect the surrounding structures. At the Josefstadt Thyroid Practice, we do not operate ourselves, but we work closely with all of the renowned Viennese thyroid surgeons.
The indication for an operation must always be made very carefully. Complications are possible and if the indication is incorrect, a previously largely healthy person can suffer from symptoms for a lifetime. The good news: in the hands of an experienced thyroid surgeon, complication rates are low.

When is thyroid surgery necessary?

Thyroid surgery is required if there is a specific suspicion of malignant cells in the thyroid (thyroid cancer or thyroid cancer) or if the thyroid tissue continues to produce hormones unchecked (hot lumps, overactive in Graves' disease). Even if the thyroid is riddled with numerous lumps or is so large that it presses on other organs, it can make sense to operate.
In any case, the underlying disease should be clarified in advance in a precise thyroid examination. This is the only way to know whether the entire thyroid gland should be removed or whether only part of the thyroid gland needs to be operated on - or whether it makes more sense to wait and see.

How does thyroid surgery work?

In a thyroid operation, all diseased tissue must be removed, but the surrounding structures should be preserved. The scope of the operation depends on the thyroid disease: In the case of thyroid nodules, the flap in which the nodule is located is usually removed (lobectomy). If both lobes are nodular, the entire thyroid is usually removed. In Graves' disease, the entire thyroid gland must be removed (total thyroidectomy), since the entire thyroid tissue produces thyroid hormones in an uncontrolled manner and causes hyperthyroidism. In thyroid cancer, too, the entire thyroid gland is removed, and sometimes lymph nodes in the neck region as well, to prevent the spread of malignant cells.

The operation removes the diseased thyroid tissue.

What method is used on the thyroid gland?

Thyroid surgery is performed using a short incision in the neck area. Endoscopic thyroid surgery is only used in individual cases - the thyroid is not so well suited for this due to its location in the body, other minimally invasive procedures are better here.

Thyroid Surgery Risks

As with any surgery, there is a general surgical risk with thyroid surgery. Harmless bruises can occur at the incision site. If the bleeding is severe, another procedure is necessary. Fortunately, these threatening complications are extremely rare.

Thyroid surgery also carries the risk of the Vocal cord nerve (Recurrent laryngeal nerve), which is only as thin as a hair and runs along the lower pole of the thyroid gland. This can lead to paralysis of the vocal cords (recurrent palsy), which leads to hoarseness temporarily or (rarely) for life.

The four small ones are also closely related to the thyroid gland Parathyroid glands. Among other things, they are responsible for the calcium balance in the body. After an extensive thyroid operation, the parathyroid glands can be damaged (usually only for a short time), which means that the calcium level in the blood can no longer be maintained, and calcium tablets must be taken for the first few days after the operation. Long-term or permanent damage to the parathyroid glands rarely occurs: The patient then has to take calcium supplements (in conjunction with vitamin D) over the long term, which is usually perceived as extremely unpleasant in the long term.

Damage to the vocal cord nerve or the parathyroid glands are possible complications of thyroid surgery.

Where is thyroid surgery done? I am looking for a good thyroid surgeon.

Thyroid operations are performed in specialized centers (e.g. in hospitals). Thyroid surgery is not performed at the Josefstadt Thyroid Practice. We carry out the examinations before an operation and look after patients after the thyroid operation. Of course, we work closely with experienced thyroid surgeons, to whom we would be happy to refer you for an operation.

After thyroid surgery

After thyroid surgery, all or part of the thyroid is missing. If there is no or too little thyroid tissue, hypothyroidism occurs. This can be balanced very well with thyroid hormones. When used correctly, thyroid hormone tablets have no side effects.
Your surgeon will usually tell you which tablets you need immediately after the operation. About six to eight weeks after the operation, you should have your thyroid function checked by a specialist. Thyroid function must be checked regularly and maintained with thyroid hormone tablets for life. The result of the operation is checked in the thyroid ultrasound; a scintigraphy is only rarely required after the operation.

Weight gain after thyroid surgery?

The sudden change from the body's own thyroid hormone (produced by the thyroid gland) to thyroid hormone tablets immediately after the operation is usually not noticed at all. The entire metabolism runs just as smoothly after the operation as before. Only in a few patients does the dosage of the thyroid hormone tablets have to be adjusted several times. With the right dose of thyroid hormone tablets you ensure a healthy metabolism.

Thyroid surgery was recommended, but I do not want to have an operation.

It is understandable that the recommendation to have an operation on the thyroid gland has to be digested first. After all, an operation is an intervention in the body and one is afraid of possible complications. In addition, the thyroid is a vital organ with numerous important functions.
First of all: the complication rate in thyroid operations is low and thyroid hormone tablets can easily take over the tasks of the missing thyroid.

If you already have a recommendation for a thyroid operation and want to get a second opinion on your findings, the specialists at the Josefstadt Thyroid Practice will be happy to advise you.

Your treating doctor will discuss any other possible treatment options with you. The recommendation for surgery is only made if other therapies are not possible or not (no longer) effective. A thyroid specialist will only recommend surgery if it is really necessary and if you can expect benefit. After all, the goal of thyroid surgery is to improve your health in the long term.

In some cases, radioiodine therapy can be performed instead of thyroid surgery. This method uses radioactive iodine-131 to specifically destroy thyroid tissue without the need for surgery.