Thyroid Surgery | Parathyroid Surgery | Los Angeles
Dr. Michel Babajanian, MD | Thyroid Surgeon | Los Angeles
Thyroid Surgery | Thyroidectomy |  Los Angeles
Parathyroid Surgery | Parathyroidectomy | Los Angeles
Parathyroid Surgery Los Angeles
Michel Babajanian, M.D. FACS | 2080 Century Park East - Suite 1700 | Los Angeles, CA 90067 | Tel: 310.785.9367
Michel Babajanian, M.D. FACS | 2080 Century Park East | Los Angeles

Thyroid Surgery - Continued

The Surgery:

Thyroid surgery, depending on its extent which is unique for every case, may take from 30 minutes for a simple biopsy to several hours for total thyroidectomy and neck lymph node dissection as necessary. Surgery is always performed tailored to the patient's specific needs and the preoperative diagnostic findings. We firmly believe in patient's informed and educated participation in the preoperative discussion and decision making regarding surgery. The date of the surgery is scheduled by our office staff by mutual agreement. Thyroid surgery is most of the time performed under general anesthesia with the plan to stay overnight after surgery. You may need to stay one or two nights after surgery at the hospital for routine post surgical observation and recovery. You will be directly under Dr. Babajanian's care. Your care will be also monitored, from the medical standpoint, by your primary care physician, either the internist or the endocrinologist. The medical/surgical team will follow you closely during your stay at the hospital. You can expect to have a sore throat on swallowing after surgery which generally resolves fully within 1-3 days after surgery. The amount of pain is generally mild to moderate and you will be able to talk and swallow and walk around in the evening of surgery. We encourage early mobilization after surgery to minimize postoperative complications and particularly since thyroid surgery is not debilitating and recovery from it is generally fast. After discharge from the hospital we will continue to be available to you directly at all times until you return to our office for your postoperative first visit usually one week after surgery. Most of the time there are no sutures to remove, and if there is a superficial skin suture, it will be removed at that time. By that time, you can expect to return to full activities including resumption of athletic and outdoor activities and return to work.

Thyroid surgery in most cases is quite successful to cure the disease both in benign and malignant cases of thyroid tumors. The extent of surgery and the success rate of cure, as well as incidence of potential complications, depend on the extent of the disease and the extent of the performed surgery. More extensive surgery is performed in more advanced cases. In a minority of very advanced cases of thyroid cancer, cure may not be achievable. In other cases of thyroid cancer, after surgery, you may need to take radioiodine treatment for further improvement of cure and prevention of recurrence. This treatment is given under the supervision of your endocrinologist who will coordinate his care with the Nuclear Medicine physician. After total thyroidectomy you will need to take a thyroid hormone in the form of a tablet to replace your body's need for that vital hormone. Patients generally do well after thyroid surgery on the replacement medication, rapidly stabilizing the amount of the medication needed. There are no significant long term problems associated with thyroid surgery.

Risks & Complications:

Thyroid surgery generally is a safe procedure with low rate of complications. The nerves controlling your voice and swallowing can be damaged during thyroid surgery resulting in temporary or permanent hoarseness, or a change in voice and swallowing. To reduce this risk, we often utilize a nerve monitoring endotracheal tube for anesthesia which simultaneously allows us to monitor any movement of the laryngeal muscles during the surgery. Nerve monitoring is particularly helpful in revision thyroid surgery and in surgical procedures involving extensive thyroid cancer or large goiters when there is higher risk to the laryngeal nerves. In addition, bleeding may occur after surgery which may result in acute respiratory distress necessitating rapid return to the operating room. Some times, as a result of damage to the parathyroid glands and their blood supply, which are located directly on or within the thyroid gland, the patient may develop low blood calcium (hypocalcemia) which is due to reduced production of the parathyroid hormone (hypoparathyroidism). Replacing the calcium deficit corrects the problem and this complication is rarely long-term. Other surgical complications include infections, formation of hematoma (blood under the skin) or seroma (collection of fluid under the skin).

The surgical scar after thyroid surgery is generally small, and relatively invisible. Particularly with minimally invasive thyroid surgery, gentle handling of the surrounding normal tissues and strict adherence to proper surgical technique, the scar after thyroid surgery has improved dramatically over time. The scars are rarely disfiguring.

Minimally Invasive Thyroid Surgery:

Minimally invasive thyroid surgery may be successfully performed for selected thyroid tumors that meet the criteria for minimal access surgery. In this type of surgery, both fiberoptic endoscopes and videoscopes are utilized to improve the visualization of the surgical field. This technique has come to be known as "Minimally invasive videoassisted thyroid surgery" (MIVAT). This operation is performed through a small 2.5-3.0 centimeter midline incision. By inserting the fiberoptic endoscopes the visualization of the surgical field is facilitated resulting in much less dissection of tissues. Special cutting and coagulating surgical instruments are required to perform sutureless ligation and cutting of the tissues. Blood loss is minimal and the speed of surgery is generally faster resulting in less anesthesia exposure time for the patient. In this surgical method, incisions are incredibly small and heal with almost no visible scar left behind. Selection criteria include small thyroid gland size (volume), nodule size smaller than 2 centimeters and absence of thyroid inflammatory disease such as thyroiditis or Grave's disease. There are yet other minimally invasive surgical approaches and techniques, each of which carries the name of its pioneer. In the hands of experienced and dedicated thyroid surgeon, with proper training, these operative procedures are generally done well with minimal rate of complications.

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Michel Babajanian, M.D. FACS | 2080 Century Park East - Suite 1700 | Los Angeles, CA 90067 | Tel.: 310.785.9367 Thyroid Surgery | Parathyroid Surgery | Los Angeles