The document describes the steps for a total thyroidectomy surgery. The surgeon makes an incision in the neck and retracts the strap muscles to expose the thyroid gland. The middle thyroid vein, superior pedicle, and inferior thyroid artery are ligated. The recurrent laryngeal nerves and parathyroids are identified and preserved. The entire thyroid gland is removed. Potential complications include hemorrhage, respiratory obstruction, recurrent laryngeal nerve injury, and hypoparathyroidism. The patient may undergo neck node dissection and receive lifelong thyroid hormone replacement therapy as well as radioactive iodine treatment after 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