Overview
Thyroid Lobectomy (Hemithyroidectomy) is removal of one half of the thyroid. You may have been told that you need to have thyroid surgery. If so, then this article is for you. It will describe what thyroid surgery is, and also describe the most commonly recommended thyroid surgery: removal of half of the thyroid gland.
Thyroid surgery can be done to remove all of the thyroid gland (total thyroidectomy) or half of the thyroid (hemithyroidectomy or thyroid lobectomy). This article will focus on thyroid lobectomy. Thyroid lobectomy is often performed to treat conditions such as benign thyroid nodules, thyroid cancer, or an overactive thyroid (hyperthyroidism). By removing only one lobe, this procedure preserves some thyroid function, which may reduce the need for lifelong thyroid hormone replacement therapy. Most patients do not require thyroid hormone replacement if they still have half of their thyroid.
Sometimes, patients ask if only a portion of a thyroid lobe can be removed, such as removal of only the nodule. In general, this is not done for a few reasons. Check out our page on partial thyroid lobectomy for more information.
Procedure
During a thyroid lobectomy, the surgeon makes an incision in the front of the neck to access the thyroid gland. The affected lobe is carefully separated from surrounding structures and removed. The procedure is typically performed under general anesthesia and may take 1-2 hours, depending on the specifics of the patient.
Hemithyroidectomy and total thyroidectomy can both usually be done without a visible scar as well. This can result in improved quality of life relative to the traditional surgery. Check out our page for "scarless thyroidectomy" for more information.
Benefits and Risks
The main benefit of thyroid lobectomy is the targeted removal of the affected portion of the thyroid, which can alleviate symptoms and prevent the progression of certain thyroid conditions. Risks associated with the procedure include damage to the recurrent laryngeal nerve, which can affect vocal cord function, and damage to the parathyroid glands, which regulate calcium levels. These risks are generally low, and your surgeon will discuss them with you in detail.
One of the big advantages to a lobectomy is that, in addition to preserving some thyroid function, the risks of low calcium are almost zero. For these reasons, at the Russell Center we generally recommend a thyroid lobectomy when it is safe to do so (rather than pushing for a total thyroidectomy).
Recovery and Follow-Up
Recovery from thyroid lobectomy typically is fairly rapid, and it is usually a surgery that is completed as an outpatient surgery (same-day surgery). Pain and swelling in the neck are common and can be managed with pain relief medications, such as acetaminophen or ibuprofen. Most patients can return to normal activities within a week or two. Thyroid hormone levels will be checked periodically, and hormone replacement therapy may be needed if the remaining thyroid lobe does not produce enough hormone. Usually, the medical management of the postoperative care is directed by the endocrinologist, and the surgical and recovery portion is managed by the surgeon.
A commonly asked question ater thyroid surgery surrounds how patients will feel after surgery. With about 500,000 thyroid and parathyroid surgeries performed annually in the USA, it is safe to say that the vast majority of patients will recover without noticing much difference. HOWEVER, it is also true that some patients may experience weight gain or have a hard time adjusting their hormones to feel "normal." This often depends on the condition that you have before surgery, ie, if you have an overactive thyroid or underactive thyroid has some impact on how you do after surgery. Fortunately, much progress has been made in the last few years regarding utilization of T3 and T4 hormonal options, and even patients who have had a hard time in the past can expect to live a normal and healthy life after thyroid surgery. And, most importantly, we are here to help!!
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