Thyroidectomy

THYROIDECTOMY

1. THYROIDECTOMY -RIYA SANJAY BAGHELE NAGPUR .

2. WHAT IS THYROIDECTOMY ? The thyroid gland is a butterfly-shaped organ composed of two cone-like lobes or wings connected via the isthmus. The gland regulates metabolism by secreting hormones. When diseases affect the thyroid, its size or activity may become abnormal . A thyroidectomy is a surgical procedure to remove all or part of the thyroid gland and used to treat diseases of the thyroid gland including : Thyroid cancer Hyperthyroidism (overactive thyroid gland) Large goiters or thyroid nodules causing symptomatic obstruction such as swallowing or breathing difficulties. Multi-nodular Goiter

3. PREPARATION OF OT FOR THYROIDECTOMY SURGERY PREPARATION OF OT ANESTHESIA POINT OF VIEW- Thyroidectomy under regional or local anesthetic may be perform safely if necessary, most cases however , are performed under general anesthesia with endotracheal tube Thyroidectomy surgery can be performed with the following type of anesthesia, Regional anesthesia Local anesthesia General anesthesia The choice of anesthesia technique may be influenced by the patient preferences and the medical history.

4. Anesthesia equipment Anesthesia machine An anaesthesia machine is a medical device used to generate and mix a fresh gas flow of medical gases and inhalational anaesthetic agents for the purpose of inducing and maintaining anaesthesia . Anesthetic vaporizers . Oxygen mask to deliver oxygen Nasal oxygen set. Yankauer suction tube. Peripheral venus catheter.

5. Artificial resuscitator [bag valve mask] manual ventilation. Laryngoscope used to view larynx including the vocal cords , the glottis etc. Spinal needle. Epidural catheter. Syringe pump. Iv set. Bivalve with extn [10cm or 200 cm] Fit fix suction.

6. Induction trolly for general anesthesia Kidney tray with oxygen mask. Magills forceps. Laryngoscope set. Lignocane jelly . Syringrs . Endotracheal tube . Ryles tube . Mac coil or buji . Gauze swab . Nasal drop . Lox 10%

7. Dinaplast sticking . Positioning of patient . The patient should be placed in a supine position with the apex of the patient's head at the top of the operating bed. A shoulder roll or gel pad should be placed at the level of the acromion process of the scapula to help extend the neck . Care should be taken to avoid hyperextension of neck and the head should be supported to provide maximum exposure of the surgical field without hyperextension .

8. Drugs used …. Atracurium Betaloc Buprenorphine Propofol [20 ml] Xylocard 2% Xylocaine 4% Enclex 0.6% Fentanyl [10ml or 2ml diluted in ns ] Mendazolum

9. Preparation of operation theater from surgical point of view

10. 3 knife handles. 15 blades. Adson tissue forceps with and without teeth . Debakey forceps. Halsted mosquito forceps. Reinhoff swan neck clamp . Allis tissue forcep . Richardson retractor. Kittner sponges. Double-pronged skin hooks. Mahorner retractor Bovie electrocautery , harmonic scalpel , shaw scalpel.

11. 13. Bipolar electrocautery forceps. 14. If intraoperative neural monitoring is to be performed , nerve monitoring leads and surface electrode primed endotracheal tube. 15. Nerve stimulator.

12. Sutures…….. Though tissue adhesive represents a valid method of skin closure, subcuticular absorbable sutures provides a better aesthetic outcome in small cervicalincision in the early phase of thyroid surgery. 3.0 vicryl suture, 2.0 vicryl interrupted suture.