After the patient is anesthetized, the surgeon extends the neck fully and determines the incision line by measuring bilaterally from each clavicle. Then he cuts through the skin, fascia, and muscle and raises skin flaps from the strap muscles. He separates these muscles midline, revealing the thyroid’s isthmus, and ligates the thyroid artery and veins to help prevent bleeding. Next, he locates and visualizes the laryngeal nerves and parathyroid glands and then begins dissection and removal of thyroid tissue, trying not to injure these nearby structures.

Before the surgeon sutures the incision, he may insert a Penrose drain or a closed wound drainage device such as a Hemovac drain.

Most often performed under general anesthesia, thyroidectomy has a low incidence of complications if the patient is properly prepared with thyroid hormone antagonists preoperatively. Potential complications include hemorrhage; parathyroid damage, causing postoperative hypocalcemia, which can lead to tetany; and laryngeal nerve damage, causing vocal cord paralysis. This last complication can result in hoarseness, if only one vocal cord is damaged, and respiratory distress (necessitating a tracheotomy), if both cords are affected. Thyroid storm is a potential complication when a thyroidectomy is performed as treatment for hyperthyroidism. It can be prevented if the patient is properly prepared with antithyroid drugs preoperatively.

Risk for injury related to potential complications associated with thyroidectomy. Based on this nursing diagnosis, you’ll establish these patient outcomes. The patient will: