Aira Hospital

Hemithyreoidectomy implicates removal of half the thyroid gland, left or right. It is used when only on lobe of the goiter is affected by disease and needs removal. The procedure is also called total lobectomy, removing a whole lobe, left or right.

Here is an example of a colloid goiter affecting only the left lobe which is removed by left Hemithyreoidectomy – left total lobectomy.

 

The skin and platysma is incised as one layer. The midline between the left and right pretracheal muscles is identified and opened by scissors.

 

Usually the pretracheal muscles are isolated and divided between straight clamps. If however the lobe to be removed is small the muscles are simply retracted without being divided.

 

The muscles are put under traction with Babcock forceps applied to the straight clamps, and the lobe is mobilized by finger dissection.

 

The lover pole vessels are isolated by finger dissection, clamped, cut and ligated

 

The middle thyroid vein is treated likevise

 

The upper pole is isolated by finger dissection, double clamped, cut and ligated using suture ligation. It is an advantage not to isolate the vessels bare, but rather include some soft tissues in the ligation. That will reduce the risk of the ligature slipping or cutting through

 

The dissection continues keeping near to the surface of the lobe, ligating the branches of the middle thyroid artery close to the gland avoiding the recurrent nerve. Finally the lobe is isolated on the isthmus (the tissue bridge between the two lobes) and is removed by clamping and cutting the isthmus between clamps.

 

The clamp on the remaining part of the isthmus is under run with a continuous absorbable suture which is returned and tied to the starting point after removing the clamp

 

The pretracheal muscles are suture together with a continuous absorbable suture applied under the straight clamps, returned and tied to the starting point after removal of the clamps

 

The skin is closed – drainage is optional.