Thyroid and Surgery - Dr.Adem Dervişoğlu, MD, Professor

Dr.Adem Dervişoğlu, MD, Professor

Thyroid and Surgery

In Which Thyroid Gland Diseases May Surgery Be Necessary?

The main reasons for deciding thyroid surgery are listed as follows:

1. The presence of hyperthyroidism; toxic nodular goiter, toxic adenoma, and Graves’ disease,

2. The patient has a thyroid nodule suggesting cancer,

3. In patients with goiter; the gland is large enough to cause cosmetic problems, it enlarges enough to protrude into the chest cavity, and creates compression symptoms (difficulty swallowing and respiratory distress).


The major risks of thyroid surgery include bleeding, hoarseness due to injury to the nerve innervating the vocal cords, and hypoparathyroidism and hypocalcemia due to injury to the parathyroid glands. In general, these risks are observed at frequencies of 1-3%. The surgeon’s level of experience is an important factor in the emergence of complications.

Standard techniques should be used by exercising meticulous care to reduce these complications. The most important of these precautions is exposing the nerves of the vocal cords, protecting them, and protect the parathyroid glands without impairing their blood supply. In many centers, thyroid surgery is performed using energy-based devices. These devices are highly safe and remove the need for ligation. Instead, they cut the tissue by sealing. The use of energy-based devices shortens the duration of surgery and reduces the quantity of bleeding.

Another technology used for protection is nerve monitoring performed during surgery. Nerve monitorization contributes to the safety of the surgery by allowing the surgeon to protect the nerve innervating the vocal cords. Continuous visual and auditory alerts are provided to the surgical team, allowing them to receive positive feedback for the conduct of a more careful surgical procedure. At the end of the surgical procedure, it is important that the surgeon takes the final measurements showing the potency of the nerves.

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