Minimally invasive thyroidectomy and Parathyroidectomy

Introduction

Thyroidectomy

A thyroidectomy is an operation that involves the surgical removal of all or part of the thyroid gland. A thyroidectomy is often performed when a patient has thyroid cancer or some other condition related to the thyroid gland.

Parathyroidectomy

Parathyroidectomy is the surgical removal of one or more parathyroid glands. This procedure is used to remove primary tumours or hyperplasia of the glands, especially when they produce excessive parathyroid hormone.

Procedure

Mini-incisionThyroidectomy

Mini-incision Thyroidectomy is a procedure that minimises surgery. A very small incision, (between two and three centimetres or 1 inch) is made along a natural skin crease in the neck to minimise the visibility of the scar. The incision is made as small as possible, given the size of the thyroid gland and the size of the patient. But the incision is made large enough to complete the operation safely with priority given to properly identifying and preserving the laryngeal nerves and the parathyroid glands. The small incision leads to a better cosmetic result and also decreases pain and speeds along recovery. Patients are generally very pleased with their results. If desired, this operation can be performed under local anaesthesia with intravenous sedation. More than 85 percent of our mini-incision Thyroidectomy patients are discharged the same day of surgery.

Minimally invasive endoscopic Thyroidectomy

Dr. Daoud has mastered the endoscopic approach to thyroid gland. In 2005, Dr. Daoud performed the first endoscopic thyroid procedure in Brisbane. Since then, numerous refinements in endoscopic thyroid techniques have led to improvements to this approach of removing the thyroid gland. With the endoscopic approach, a small incision is made in the neck. A small camera (endoscope) is inserted in the tunnel to allow visualisation of the thyroid gland and surrounding anatomy. The endoscopic view provides an illuminated, magnified view of the operative field, permitting the surgeon to perform a safe thyroid procedure. Our surgeons can perform partial or total thyroid removal with this approach, including patients with stage 1 thyroid cancer and Graves' disease. In addition to the improved view of thyroid anatomy, the main advantage of endoscopic thyroidectomy is that the incision and subsequent scar is very small. More than 70 percent of our endoscopic thyroid patients are discharged the same day of surgery.

Bilateral Neck Exploration for Hyperparathyroidism

Dr Daoud has considerable experience in treating even the most complicated parathyroid conditions with bilateral neck exploration. If necessary, all of the diseased parathyroid glands will be identified and appropriately treated.

Minimally Invasive Endoscopic Parathyroidectomy

Dr. Daoud performs video-endoscopic parathyroidectomy removal using a small camera to allow visualisation of the thyroid and parathyroid glands, permitting the procedure to be performed safely.

Postoperative Instructions

Pain

Post-operative pain is normal but the intensity can differ between individuals. Analgesia will be given to you during your hospital stay and made available to you on your discharge if still required. It is important to avoid sudden movements and brace your neck when you cough or move to avoid pain. Please read the section “Medications”.

Wound

The dressing will normally be taken down the day after your surgery. You may have a dry dressing to cover the wound if you wish and this dressing needs to be kept dry until the clips or sutures are removed. The incision usually heals very quickly.

Food

Swallowing and eating may be difficult for the first day or two as you will have some soreness and swelling around the neck. Once you feel up to it you, may go back to your normal diet.

Nausea and vomiting

Some people are very sensitive to surgical procedures. Nausea and vomiting may occur as a result of the general anaesthesia, the procedure performed or the medications prescribed.

If you have nausea and vomiting please do the following:

• Keep well hydrated with frequent small drinks of clear fluids. It is recommended that you drink water, lemonade or diluted fruit juice. Avoid milk.
• Cease your medications as in most cases the nausea and/or vomiting is related to the antibiotics prescribed. Once these have been ceased the nausea/vomiting will usually resolve.
• Contact Dr Daoud’s rooms at Greenslopes on 3397 8499 if the nausea and/or vomiting persist.

Activities

You will be encouraged to take short walks, although this will probably start the morning after your surgery. You should be able to return to most normal activities within one to two weeks.

Medications

If you are taking medications prescribed by your doctor you need to return to your normal dosage schedule as soon as possible after surgery unless directed otherwise.

Sutures

If you have surface sutures or clips you should keep your wounds clean and dry. Keeping your wound clean and dry will help to prevent infection. You should have your sutures or clips removed in 6-7 days.

Follow up

You will need to contact the receptionist at Dr Daoud’s office to make a Postoperative review appointment for one week after your surgery. It is at this appointment that you will have the sutures or clips removed.

Infection

If you develop a post-operative infection remember it will not generally appear until one to two weeks after your operation. If this does occur, please call Dr Daoud’s office to book a review appointment. You will normally be prescribed a course of antibiotics.

It is important that the full course of antibiotics is completed.

Problems

Post-operative complications such as infection, unusual pain etc are uncommon but if they do occur please contact Dr Daoud for advice.

Please do not call the referring doctor or your local general practitioner before you call Dr Daoud. Most problems can be helped by making a simple phone call.

Return to work/school

You can expect to return to a normal routine after 14 days. If you require a medical certificate please call Dr Daoud’s rooms and one will be arranged.

Special issues of concerns

Please feel free to call Dr Daoud’s rooms during office hours or mobile after hours of any doubt arises as to your progress or recovery, especially if any of the following occur:

• Increasing or persistent pain after 4 or 5 days.
• Any swelling around the wound site.
• Redness or heat around the wound site.
• Persistent nausea or vomiting.
• Persistent discharge from the wound site.

For 24-hours postoperatively remember

• DO NOT drive any motor-vehicle or operate machinery.
• DO NOT undertake important new projects, make important decisions or sign legal documents.
• DO NOT drink any alcohol what-so-ever. Alcohol and prescribed medicines make a dangerous mixture.

Medications you may take after your surgery

You will generally be prescribed an antibiotic and analgesia. It is imperative that you notify Dr Daoud of any allergies you have to medications.