Canberra Endocrine & General Surgery

Types of Thyroid Surgery
 
Depending on the condition and extent of disease, different surgical approaches may be considered:
​

• Lobectomy (Hemithyroidectomy): Removal of one lobe of the thyroid gland.

• Total Thyroidectomy: Complete removal of the thyroid gland.

• Near-Total Thyroidectomy: Removal of almost the entire thyroid, leaving a small amount of tissue.

• Isthmusectomy: Removal of the central part of the thyroid gland.

 
The specific procedure recommended will be based on individual assessment and diagnostic findings.

Risks and Complications

While thyroid surgery is generally safe, as with any surgical procedure, there are potential risks, including:
​

• Voice Changes: Injury to the recurrent laryngeal nerve, which controls the vocal cords, can lead to hoarseness or voice changes.

• Hypoparathyroidism: Accidental removal or damage to the parathyroid glands, which regulate calcium levels, can result in low calcium levels.

• Bleeding and Infection: As with any surgery, there is a risk of bleeding and infection.

• Scarring: Although efforts are made to minimise scarring, some patients may experience visible scars.

 
It's important to discuss these risks with Dr Hazel Serrao-Brown to understand how they apply to your specific situation.

Thyroid Hormone Replacement

If the entire thyroid gland is removed, lifelong thyroid hormone replacement therapy will be required to maintain normal metabolic function. This involves taking synthetic thyroid hormone daily to replace the hormones the thyroid would normally produce.
Patients who have had partial thyroid removal may not require hormone replacement, but this will be determined based on individual thyroid function tests.

Symptoms to Watch for After Thyroid Surgery


Voice Changes or Hoarseness
Mild hoarseness is common in the first few days due to irritation from the breathing tube or swelling around the vocal cords.

Concerning signs: Persistent hoarseness, weak voice, or difficulty speaking lasting more than a few weeks may suggest injury to the recurrent laryngeal nerve and should be assessed.

Difficulty Breathing or Swallowing
Mild discomfort when swallowing is expected.

Concerning signs: Shortness of breath, a sensation of choking, or difficulty breathing may indicate swelling, bleeding, or a rare condition called a neck haematoma and requires immediate emergency care.

Swelling or Tightness in the Neck
Minor swelling at the incision is normal.

Concerning signs: Rapidly increasing swelling or firmness around the surgical site could indicate bleeding or haematoma and needs urgent review.

Tingling or Numbness in Fingers, Lips, or Face
This can be a sign of low calcium levels (hypocalcaemia) due to temporary or permanent damage to the parathyroid glands during surgery.

Concerning signs: Persistent tingling, muscle cramps, or twitching. This needs prompt treatment with calcium supplements.

Fever or Signs of Infection
Slight fever after surgery is not uncommon.

Concerning signs: Persistent or high fever, redness, warmth, discharge, or worsening pain at the incision site may indicate infection.

Fatigue or Weakness
A general sense of tiredness is expected while the body adjusts, especially if thyroid hormone replacement is started.

Concerning signs: Severe or worsening fatigue may indicate under-replacement of thyroid hormone or another complication.

Bleeding
Mild oozing or bruising is common.

Concerning signs: Significant bleeding from the wound or into the neck tissues, particularly if it leads to breathing difficulty, needs emergency treatment.
 

Surgical Procedure
 
Thyroid surgery is typically performed under general anaesthesia. The procedure involves making an incision in the neck to access the thyroid gland. The size and location of the incision depend on the type of surgery being performed and the patient's anatomy.
In some cases, minimally invasive techniques may be employed, resulting in smaller incisions and potentially quicker recovery times.

Recovery and Aftercare
 
Post-operative care is crucial for a smooth recovery. Patients are typically monitored for a short period following surgery and may be discharged the same day or after an overnight stay, depending on the procedure and individual recovery.

Follow-up appointments with Dr Hazel Serrao-brown will be scheduled to monitor healing, assess thyroid function, and adjust any necessary hormone replacement therapy.

Preparing for Surgery

 Prior to surgery, a thorough evaluation will be conducted, including:

​

• Medical History Review: To assess overall health and suitability for surgery.

• Blood Tests: To evaluate thyroid function and other relevant parameters.

• Imaging Studies: Such as ultrasound or CT scans, to assess the size and location of the thyroid and any nodules.

 
Patients should inform Dr Hazel Serrao-Brown & her surgical rooms of any medications they are taking, allergies, or other medical conditions that may affect the surgery or recovery process. 

Expected Post-Operative Symptoms (Normal)

These are common and typically improve within days to weeks:

​

• Mild neck pain or stiffness

• Bruising or swelling around the incision

• Sore throat or hoarseness from the breathing tube

• Fatigue – common while your body adjusts, especially if starting thyroid hormone replacement

• Mild difficulty swallowing solids or feeling of “tightness” in the neck

These symptoms should gradually improve. If they worsen or persist beyond 1–2 weeks, notify Dr Hazel Serrao-Brown.