Left Thyroid Lobectomy and Isthmusectomy

Abstract

Open thyroidectomy remains the most common approach for management of benign and malignant thyroid pathologies. While recurrent laryngeal nerve monitoring (RLNM) has become an increasingly popular adjunct in thyroid surgery over the past few decades, no large scale multi-institutional studies have demonstrated a significant difference in RLN injury rates with its use and many high-volume surgeons continue to rely solely on intraoperative visualization and knowledge of normal and variant anatomy to preserve RLN structure and function during thyroidectomy. In addition, novel hemostatic devices such as electrothermal bipolar vessel sealers and ultrasonically activated shears have become increasingly utilized in thyroid surgery; while these tools have been shown to be effective, they are also more expensive than traditional modes of effective hemostasis such as knot tying, clips, and monopolar electrocautery. In this chapter, a safe, reliable, efficient and low-cost technique for left thyroid lobectomy and isthmusectomy, without the use of RLNM or a vessel-sealing device, is described.