Isthmusectomy

Overview‍

An isthmusectomy is a surgical procedure that involves the removal of the thyroid isthmus, the small bridge of tissue connecting the two lobes of the thyroid gland. This procedure is typically performed to treat localized conditions such as small nodules, tumors, or cysts located in the isthmus or to assist in further diagnostic evaluation. By removing only the isthmus, the majority of thyroid function can be preserved, reducing the likelihood of requiring hormone replacement therapy. Surgical risks are also generally lower. As with most thyroid surgery, however, the less thyroid tissue that is removed, the greater the risk of recurrence.

Procedure‍

During an isthmusectomy, usually the surgeon makes a small incision in the front of the neck to access the thyroid isthmus. The isthmus is carefully separated from the surrounding thyroid lobes and tissues, and the affected portion is removed. The remaining thyroid lobes are left intact. This procedure is generally performed under general anesthesia and typically takes about one to two hours, depending on the case's complexity. The Russell Center for Endocrine Health and Dr Jon Russell are one of the only groups in the world to offer isthmusectomy without a visible scar.

Benefits and Risks‍

The main benefit of an isthmusectomy is that it targets and removes problematic tissue in the thyroid isthmus while preserving the function of the remaining thyroid gland. This can potentially reduce the need for lifelong thyroid hormone replacement therapy. However, like any surgery, there are risks involved, including possible damage to nearby structures, such as the recurrent laryngeal nerve, which can affect vocal cord function. The risks of recurrence or the need for more surgery in the future are also relevant. Your surgeon will explain these risks in detail to ensure you are fully informed before the procedure.

Recovery and Follow-Up‍

Recovery from an isthmusectomy is typically quicker than more extensive thyroid surgeries. Most patients can resume normal activities within a week. Some pain and swelling in the neck are common and can be managed with pain relief medications. Regular follow-up appointments are important to monitor thyroid function and ensure the remaining portions of the thyroid are working properly. In certain cases, additional treatments may be necessary depending on the final pathology results.

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