HOW I DO IT / HOW I DID IT SURGICAL PROCEDURES

 

PARTIAL  LOBECTOMY (Thyroidectomy)

 

Operative Technique:

§      Patient lying supine with hyperexteded neck under GA

§      Asepsis antisepsis technique done

§      Sterile drapes placed

§      A low collar incision done carried down to the subcutaneous tissue

§      Platysma identified

§      Superior flap created by blunt  and sharp dissection up to the level of the thyroid cartilage

§      Inferior flap created by blunt and sharp dissection and mobilized just up to suprasternal notch

§      Incised the fascia in the midline up to the thyroid gland

§      Strap muscles identified, dissected and separated from the thyroid gland

§      Pass a blunt-tipped hemostat between the isthmus and the trachea

§      Divide the isthmus at is narrowest area or at the far side

§      Divide the lobe by placing a Kelly clap in an angle that will preserve the posterior capsule of the thyroid (leaving a remnant thyroid gland approximately 5 gms)

§      Suture ligate the thyroid by using silk 4-0

§      Tack the thyroid remnant to the trachea with running suture through the tough pretracheal fascia

§      Hemostasis

§      Drain placed

§      Layer by layer closure

§         Strap muscle approximated using chromic 3-0

§         Subcutaneous approximated using chromic 2-0 by inverted T suture

§         Skin closed by subcuticular using vicryl 4-0

§      Betadine

§      DSD

§      Patient tolerated procedure well

§      Post-op condition-stable