Surgery for Hyperthyroidism
Surgery may be an option for some people with hyperthyroidism, such as people who cannot have radioactive iodine ablation. Your NYU Langone endocrinologist may recommend a procedure to remove the entire thyroid, which is called a total thyroidectomy, or to remove a portion of your thyroid gland, which is called a lobectomy.
For people with Graves’ disease or a toxic nodular thyroid, doctors may recommend a total thyroidectomy. This procedure requires general anesthesia and takes about two hours.
Your surgeon makes a small incision in the front of the neck and removes the entire thyroid gland. Doctors use minimally invasive surgical techniques to help reduce bleeding and trauma to the surrounding tissue. After the gland is removed, the incision is closed with dissolvable stitches.
You can usually go home the morning after surgery. You may experience slight discomfort in the neck. A sore throat may occur, but it usually subsides within two days. If it persists, call your doctor.
When the entire thyroid gland is removed, you must take a synthetic thyroid hormone called levothyroxine for the rest of your life. This medication is taken by mouth once a day, and most people are able to tolerate it well.
Thyroid Lobectomy with Isthmusectomy
If you have a single toxic nodule in the thyroid, a doctor may recommend a lobectomy with isthmusectomy. This surgical approach is the same as with thyroidectomy, but only half of the thyroid is removed during this procedure.
Your thyroid is composed of a right and left lobe, and they are connected by a thin strip of tissue called the isthmus. In this procedure, your surgeon removes the lobe that contains the nodule, as well as the isthmus.
Care after surgery is identical to that of a thyroidectomy, except that you are not automatically given thyroid hormone replacement medications. Part of your thyroid remains after this procedure, and it may be able to produce sufficient thyroxine.
During follow-up visits, your endocrinologist determines whether medication is necessary by using blood testing to measure the level of thyroid-stimulating hormone, or TSH, which is a hormone made in the pituitary gland that signals the thyroid to increase hormone production.