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Minimally invasive thyroid surgery Minimally invasive thyroid surgery is the removal of one half or whole thyroid gland through a small mid neck incision. The incision is placed in the natural skin crease. Minimally invasive thyroid surgery includes video-assisted or endoscopic thyroidectomy, when surgeon uses camera to magnify the view. This technique makes the healing process faster and with minimum scar formation. Scar 2 weeks after thyroid surgey:
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YOUR SURGERY: Anesthesia The procedure is done either under general or local/regional anesthesia with general sedation. The later one helps surgeon to use voice monitoring and avoid injury to important nerves which go to your vocal cords Length of hospital stay Surgery is performed as an outpatient procedure. The average stay after the surgery is about 6 hours. Most patients do not require overnight stay. Pain Most patients have little or no pain. The neck block last for about 8 hours. Some patients may feel discomfort or pressure after the surgery. Some patients may feel discomfort or pain with swallowing after the surgery. It normally resolves within couple of days. Some patients might feel shoulder/arm weakness after the neck block, which also resolves within 4-8 hours after the surgery Postoperatively most of the patients have no pain at all. If you do develop mild pain at home, you can take either Tylenol or Motrin. Drain: there will be no drains. Stitch and Scar: The stitches will be removed the day of the surgery, right before you go home. You will have just a strip of skin glue on the skin. It will peel off on its own in about 6 - 10 days. Because the incision will be small and the stitch will be removed the same day of the procedure the size of the scar will be much less than that with traditional thyroid surgeries performed in the past. The incision will be placed in the natural skin crease of your neck, which will help to make it less noticeable or not visible at all. However the scaring tendency is dependent on the individual skin healing proprieties. The surgeon will make all efforts to have best cosmetic result possible. Complications: Voice changes: Only 1% (1 in 100 patients) experience complications related to the damage of the nerve goes to the vocal cords. When this occurs the patient will have hoarse voice or inability to make high-pitched sounds. More commonly hoarseness lasts for a couple of days. In about 1 in 50 operations patient might experience temporally voice changes which resolve in 8 to 12 weeks. Low calcium level: In about 0.5% (1 in 200 operations) for total removal of thyroid gland the patient may experience low calcium levels. It happens secondary to malfunction of parathyroid glands, which are located on the or near the thyroid gland and have the same blood supply as the thyroid gland. If it happens, patients need to stay on calcium and vitamin D supplementation permanently. Because there are four parathyroid glands, this is a rare occurrence. Because of the nature of the surgery, all patients with total thyroid removal will go home on calcium pills for 2-3 weeks. If patient develops cramps in the hands or legs, or tingling of the face muscles it will indicates that the calcium level is low. In this case you should immediately take 2 Calcium pills (1000 mg) and call your doctor. Bleeding: With current technique the incidence of bleeding is close to zero. Wound infection: With current technique the incidence of wound infection is close to zero. You do not need any antibiotics for the surgery, unless you have condition which requires you to take antibiotics with every procedure. POSTOPERATIVE CARE: Incision site: The skin glue will peel off on its own in 6-10 days. After that you can apply you can use Mederma or lotion with Vitamin E 3-6 times a day to the wound. Try not to have sun exposure to the wound for about 1-2 months (especially during summer months), such as it will cause skin discoloration in the wound area and it will look different from the other skin areas. Physical restrictions: It is better not to drive for several days if you feel uncomfortable moving your neck. Do not drive if you are taking narcotics such as Percocet or Vicodine. There are no significant physical restrictions, but it is not advisable to do any stretch exercises to your neck for 2-3 weeks. Most of the patients resume their normal physical activities within day after the surgery. Shower: You can take shower in 2 days after the surgery. Do not scratch or peel off the skin glue, just wipe it with the towel. Pathology report: Usually available within 5-7 days after the surgery Problem calls: Please immediately call doctor if you develop significant neck swelling or shortness of breath shortly after surgery, or you develop cramps in your hands or legs after the surgery. Postoperative visit: 2-3 weeks after the surgery: for wound check and pathology report.
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