What is an Open Thyroid Lobectomy

Open thyroid lobectomy is a surgery to remove a part or a whole section (lobe) of the thyroid gland. The thyroid gland is a butterfly-shaped gland at the base of the neck.

It produces thyroid hormone, which is a substance that helps to control certain body processes. The thyroid gland has two lobes, one on each side of the windpipe (trachea). The lobes are joined together by a section of tissue in the middle (thyroid isthmus).

You may have a thyroid lobectomy:

• To remove a non-cancerous (benign) tumor or a cancerous (malignant) tumor of the thyroid.
• To control the overproduction of thyroid hormone (hyperthyroidism).

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Hoarseness or vocal cord (vocal fold) damage.
• Difficulty swallowing or eating.
• Damage to the glands that control the calcium level in your body (parathyroid glands).
• Scar formation.
• Overproduction of thyroid hormone.
• Temporary breathing difficulties. This is a very rare complication, and it usually goes away within weeks.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
• You may be given antibiotic medicine to help prevent an infection.

General instructions

• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be asked to shower with a germ-killing soap.
• You may have an exam or testing. Your health care provider will assess your voice for vocal changes.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given a medicine to make you fall asleep (general anesthetic).
• The surgeon will make an incision just above where your collarbone meets your breastbone.
• The surgeon will separate the muscles in your neck to access your thyroid gland.
• The damaged or diseased part of the gland will be identified and removed. While your surgeon does this, he or she will be careful to avoid the nerves of your voice box (larynx) and the four parathyroid glands that are located close to the thyroid gland.
• The incisions will be closed using stitches (sutures), skin glue, or adhesive strips. The stitches are often hidden under the skin.
• You may have a drainage tube placed at the incision site to drain blood and fluids that build up under your skin after the procedure. This may have to stay in place for a day or two after the procedure.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• Your throat may be sore, and you may have some pain at the incision area.
• You may have a blood test to check the level of calcium in your body.
• You will be encouraged to start drinking liquids.

Summary

• A thyroid lobectomy is a surgery to remove a part or a whole section (lobe) of the thyroid gland.
• This surgery may be done to remove a tumor or to treat overproduction of thyroid hormone (hyperthyroidism).
• Before the procedure, follow instructions from your health care provider about eating and drinking.
• During the procedure, you will be given a medicine to make you fall asleep.

Open Thyroid Lobectomy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Mild pain in the neck or upper body, especially when swallowing.
• A sore throat.
• A weak voice.

Follow these instructions at home:

Activity

• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
• Do not jog, swim, or do other activities that take a lot of effort until your health care provider approves.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take medicines that contain aspirin and ibuprofen until your health care provider says that you can. These medicines can increase your risk of bleeding.
• Do not drive or use heavy machinery while taking prescription pain medicine.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• If you were sent home with a surgical drain tube in place, follow instructions from your health care provider about emptying it.

General instructions

• Follow instructions from your health care provider about eating or drinking restrictions. You may need to have only liquids and soft foods for a few days after the procedure.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider when you can take showers.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • If you need to have only liquids, try options such as fruit smoothies.
    • If you need to have soft foods, try options such as cooked fruits and vegetables and oatmeal.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• The soreness in your throat gets worse.
• You have redness, swelling, or pain around your incision.
• You have fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision area.
• You have a fever.
• You feel light-headed, or you faint.
• You have numbness, tingling, or muscle spasms in your arms, hands, feet, or face.
• You have trouble swallowing.

Get help right away if:

• You develop a rash.
• You have difficulty breathing.
• You hear whistling noises coming from your chest.
• You develop a cough that gets worse.
• Your speech changes, or you have hoarseness that gets worse.

Summary

• After the procedure, it is common to have a sore throat, a weak voice, and mild pain in the neck or upper body.
• Follow instructions from your health care provider about eating or drinking. You may need to have only liquids and soft foods for a few days after the procedure.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Make sure you know the signs of a possible problem and when to contact your health care provider.