total thyroidectomy papillary carcinoma,surgery

1. TOTAL THYROIDECTOMY
Andrea

2.  Position-rose position
 Incision-kochers thyroid incision

3.  Skin and platysma are incised
 Held in position by jolls retractor
 Deep fascia opened vertically in midline
 Strap muscles retracted
 Pretracheal fascia opened vertically to expose
thyroid gland
 Middle thyroid vein ligated first

4.  Superior pedicle dissected
 Artery and vein are ligated individually
 Parathyroids –both identified and dissected
 Recurrent laryngeal nerve identified and care taken
not to injure it
 Capsular ligation of inferior thyroid artery
 Entire gland is removed

6.  Drain is placed and suturing is done
 Complication –hemorrhage
 respiratory obstruction
 recurrent laryngeal nerve palsy
 hypoparathyroidism

7.  Lateral neck node dissection
 Suppressive dose of L-thyroxine 0.3mg OD lifelong
 After 4-6 wks of surgery radioiodine therapy

8. THANK YOU