Surgery of the thyroid has been a long standing part of my practice. see figure
Influenced by my father who was an excellent thyroid surgeon I concentrated on this procedure from the very beginning of my career. Quality of thyroid surgery is measured by damage rates to the vocal cord nerve (recurrent laryngeal nerve) and postoperative bleeding as well as the cosmetic aspect of the incision.
I prefer a rather “biological”, organ preserving operation, if possible. That means only diseased thyroid tissue is removed and the healthy parts are spared. When operating for cancer of the thyroid or for severe hyperthyroidism (Graves’s disease) the whole organ has to be removed. On the other hand when we deal with well defined nodules of the thyroid, the healthy parts can be spared. This preserves a functioning rest of the gland and makes adjusting the hormone level after the operation a lot easier.
In selected, technically difficult operations I use a nerve stimulating device to enable anatomical preparation and preservation of the recurrent laryngeal nerve.
After partial or complete resection of the thyroid, lifelong intake of thyroid hormones is necessary to prevent enlargement of the rest of the thyroid after partial resection or substitute the hormone level after total thyroidectomy.