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HOW I DO IT / HOW I DID IT SURGICAL PROCEDURES |
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TOTAL 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 § Middle thyroid vein identified, ligated with silk 4-0 and cut § Mobilization of the superior pole of the thyroid done § Superior parathyroid gland identified § Superior thyroid artery and vein is identified, clamped , doubly legated and cut § Mobilization of the inferior pole of the thyroid § Inferior parathyroid gland identified § Recurrent laryngeal nerve identified § The inferior thyroid artery and vein identified, clamped. Cut and ligated § Gently do a blunt dissection of the isthmus from the trachea § Isthmus clamped, cut and suture ligated § 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 |