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Thyroidectomy Video with Steps

Thyroidectomy steps and video

  1. GA, head ring, shoulder bolster to extend the neck
  2. Transverse incision 2 cm above sternal notch
  3. Skin, subcutaneous fat and platysma are incised transversely
  4. Investing fascia and connective tissue between the sternohyoid and sternothyroid muscles are incised vertically. 
  5. Usually the strap muscles are not divided, but this may be necessary in case of large got results.
  6. If they do need to be divided this should be done as high as possible (ie above the point of entry of the ansa cervicalis nerve branches) to prevent denervation and muscle wasting
  7. Pretracheal fascia around the thyroid is incised
  8. Thyroid lobe is mobilised
  9. RLN is identified
  10. Traditionally, the superior thyroid artery is tied off close to the thyroid gland (to protect the ELN) and the inferior thyroid artery is tied off laterally away from the thyroid (to protect the RLN). However, many surgeons now divide the branches of the inferior thyroid artery individually on the gland to protect the blood supply to the parathyroids
  11. If a parathyroid is excised, it can be cut up and implanted in the sternomastoid. The majority of these continue to function normally
  12. Thyroid gland is excised
  13. Haemostasis, suction drain, closure in layers (approximate strap muscles and platysma), skin closure

Chalmers, Claire Ritchie. “MRCS Part A: Essential Revision Notes Book 2
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Thyroidectomy Video with Steps