Minimally invasive thyroid surgery • Atlas General Hospital

Minimally invasive thyroid surgery

16-07-2018
štitasta žlezda operacija vest

Thyroid gland is the largest endocrine gland in human body. It is situated  in the front part of the neck, below the trachea, between the cricoid cartilage and suprasternal notch (below the Adam’s apple) and its form resembles the shield or butterfly. Thyroid gland creates and releases thyroxine (T4) and thyronine (T3) which regulates metabolism of all other body tissues. Increased and decreased secretion of thyroid hormones could throw the heart out of its natural rhythm, can affect the metabolism, nervous system, and in women can affect reproductive life. Number of sick men is increasing while every fifth women in some period of life have thyroid gland disorder. Dysfunction in thyroid gland today are common endocrine problem just after the diabetes mellitus.

What is the main cause of thyroid problems

Except genetics, occurrence of thyroid diseases cause stressful way of life, eating irregular meals and change in hormonal status beside pregnancy and menopause. First symptoms of thyroid dysfunction  are swelling of the neck, unexplained loss or gaining weight, loss of hair or changes in energy level and mood changes. Signs that points to thyroid gland dysfunction that controls metabolism can be related to fertility but also with hypertension, heart damage as well as psychological problems in form of depression.

Thyroid gland diseases 

The most often diseases are hypothyreosis when secretion of hormones is diminished. Symptoms are different depending on the causes of disorder.

What is hyperthyroidism?

The most common cause of insufficient secretion of thyroid gland are autoimmune diseases -Hashimoto’s disease that is confirmed with testing of antibodies of thyroid peroxidase (TPO) and thyroglobulin (Tg).

Autoimmune disease can be present even if there is no hormonal disbalances but it is necessary that the condition is tested and controlled by the doctor because even in this case there are symptoms of the disease.

Symptoms of hyperthyroidism

Gain weight without significant food intake, water retention in the body, constipation and digestive problems, constant tiredness and lack of energy, disbalances of menstrual cycle, dry and  flaking skin, hair loss, swelling on the neck, goiter, hypertension, heart palpitation, feeling of coldness  because of slow metabolism, depression, psychomotor impairment, infertility.

Hyperthyroidism treatment is most often performed with substitution of natural hormones of thyroid gland with synthetic ones that should be taken on en empty stomach depending on the dose the patient needs.

operacija štitne žlezde

What is hyperthyroidism?

In hyperthyroidism there is increased secretion of thyroid hormones, and most often it is caused by the autoimmune diseases namely Graves’s disease.  Other causes are nodules and pituitary disorders. Symptoms are often more present then in hypothyreosis.

Symptoms of hyperthyroidism:

Increased heart rate, excessive sweating, unexplained weight loss, frequent stools, subjective feeling of heat, tremor of hand and body muscles, hair loss, brittle nails, swelling of the neck, nervousness and psychological (inner) turmoil, hyperactivity, insomnia, menstrual cycles disorders, vision issues and protruding eyes, high blood pressure.

Hyperthyroidism treatment includes therapy with antithyroid medicines that block creation and releasing of thyroid hormones as well as beta blockers that are slowing down the heart rate. As therapy can result with side effects like reduction of leukocytes but is not for life.

If there is no withdrawal of the symptoms, then treatment with radioactive iodine should be applied with partial or complete removal of the thyroid gland.

In this way the body is brought into the hypothyroidism, so it is necessary to continue the treatment with synthetic hormones.

 

Thyroid disorders diagnostic

The most common method to establish the diagnosis is hormonal analysis of the thyroid gland from the blood.  If the level of hormones is optimal, then an ultrasound examination of the thyroid is performed. If the nodules in the thyroid tissue are present, puncture and scintigraphy is performed.

In some cases problem can vanish without treatment, while in most cases medicament therapy is needed.

When nodules are present, like in hyperthyroidism that cannot be controlled for long time, operation of the thyroid gland or radiation with radioactive iodine are performed.

 

Minimally invasive thyroid surgery

prof-Diklic Aleksandar

In our constant endeavour to promote surgical procedures and surgical techniques in this hospital, recently we have introduced in our constant procedures also minimally invasive thyroidectomy.

Minimally invasive thyroidectomy differs from classical one because the incision is smaller and also the trauma of the surrounding tissue and muscles, and at the end,  there is no surgical drain, recovery is faster and return to daily activities is shorter, while patient can go home several hours after operation. Because of the minimally trauma to the surrounding tissue patient can return to ordinary activities the day after the intervention.

First control after the operation is performed the next day when small adhesive plaster is taken off and further dressing is not needed. Regarding the fact that there are no sutures, first control is two weeks after the operation.

 

 Complication of thyroid surgery

One of the main complication in classical approach is a laryngeal nerve damage that can cause hoarseness and even loss of voice.

In minimally invasive thyroidectomy occurrence of this nerve damage is the same or smaller, while in expert surgeon hands is very small.

Smaller postoperative scar and smaller pain can occur in minimally invasive surgery of the thyroid gland. Aesthetic effect should not be ignored regarding the fact that the cut is smaller and that during closure of the wound  it is taken care that postoperative scar should be as small as possible.

 

 

Experts team of the Atlas General Hospital that performs minimally invasive thyroid surgery are: prof. dr Aleksandar Diklić and  dr  Goran Zorić, recognized experts in the field of an endocrine surgery.