Endocrine

Thyroidectomy (Total)

THYROIDECTOMY (TOTAL)

Indication: Thyroid carcinoma (papillary, follicular, medullary), Graves' disease refractory to or unsuitable for radioiodine, large multinodular goitre causing compressive symptoms, indeterminate or suspicious FNA cytology requiring complete gland removal, toxic multinodular goitre.

Patient Position: Supine, neck extended with a sandbag or ring between the shoulders. Arms at sides.

Anaesthesia: General. Intraoperative nerve monitoring (NIM) electrodes placed for recurrent laryngeal nerve (RLN) monitoring.

Prophylactic Antibiotics: Per local protocol (not routinely required).

Incision: Transverse (Kocher) skin crease incision approximately 2 finger-breadths above the sternal notch.

Procedure:
1. Skin incision through platysma. Superior and inferior subplatysmal flaps raised.