Endocrine

Thyroidectomy (Total) with Central Neck Dissection

THYROIDECTOMY (TOTAL) WITH CENTRAL NECK DISSECTION

Indication: Medullary thyroid carcinoma (requires total thyroidectomy and central lymph node dissection). Also for papillary thyroid carcinoma with confirmed nodal disease in the central compartment (Level VI), or high-risk papillary carcinoma with large primary tumour and extrathyroidal extension.

Patient Position: Supine, neck extended.

Anaesthesia: General with RLN monitoring.

Incision: Kocher transverse incision, extended laterally if lateral neck dissection required.

Procedure:
1. Total thyroidectomy performed as described, with bilateral RLN identification and parathyroid preservation.
2. Central compartment (Level VI) dissection: