Endoscopic thyroid surgery (endoscopic thyroidectomy) is a minimally invasive way of removing all or part of the thyroid gland. Instead of one long cut across the front of the neck, the surgeon works through a few small incisions using a thin camera (endoscope) and long, fine instruments. The goal of the operation is the same as in open surgery – to remove the diseased part of the thyroid safely – but the scar is smaller and, with some techniques, hidden away from the neck.
At Delta Clinic & Hospital, Varanasi, thyroid surgery is performed by Dr. Om Prakash Prajapati (MBBS, MS, MCh), endocrine and breast cancer surgeon. Whether an endoscopic approach is right for you is decided only after a proper examination and tests.
How is endoscopic thyroidectomy different from open surgery?
- Incisions: a few small cuts instead of one long neck incision. Depending on the technique, they can be placed in the neck, or away from the neck (for example inside the mouth, in the armpit or on the chest) so that no scar shows on the neck.
- View: the camera magnifies the area, which helps the surgeon see the small nerves and the parathyroid glands near the thyroid.
- Outcome: the thyroid is removed completely or partly, exactly as it would be in open surgery. Endoscopic surgery is chosen mainly for a better cosmetic result and a comfortable recovery, not because it treats the disease differently.
The surgeon chooses the approach after examining you, looking at your scans and discussing your wishes. If the operation cannot be completed safely through the small incisions, it is converted to conventional open surgery. This is done for your safety and is explained to you before the operation.
Who may be suitable for endoscopic thyroid surgery?
Endoscopic thyroid surgery is usually considered for carefully selected patients, for example:
- benign (non-cancerous) thyroid nodules or goiter of limited size,
- selected small, low-risk thyroid cancers that have not spread beyond the thyroid,
- patients who are particularly concerned about a visible neck scar, such as young women, teachers, singers, anchors and others who are often in the public eye.
It may not be suitable if the thyroid is very large, if a cancer is advanced or has spread to the lymph nodes, if you have had earlier neck surgery or radiation, or if you have other medical conditions that make a longer operation unsafe. Open surgery remains the right and safe choice for these patients. Only a specialist can tell you which group you belong to.
Tests before surgery
- Thyroid blood tests (TSH, T3, T4) and, where needed, calcium and vitamin D levels
- Ultrasound of the neck, and other scans if the doctor advises
- FNAC (needle test) of a thyroid nodule
- Check of the vocal cords, and routine pre-anaesthesia fitness tests
Please bring all your earlier reports and scans to the consultation.
How is the operation done?
- The operation is done under general anaesthesia, so you do not feel anything.
- Small incisions are made and a working space is created under the skin.
- The endoscope and fine instruments are passed through the incisions. The surgeon carefully separates the thyroid from the nerve that controls the voice and from the parathyroid glands, which control calcium.
- The thyroid (the whole gland or one half, as planned) is removed through one of the incisions and sent for examination.
- The incisions are closed with fine stitches. A small drain may be kept for a short time.
Benefits of endoscopic thyroid surgery
- Smaller, less noticeable scars, and with some techniques no scar on the neck
- Magnified view of the surgical area
- Comfortable recovery, and an early return to normal routine for most patients
- Better satisfaction with appearance, which matters a lot for many patients
Possible risks
As with any thyroid operation, there are some risks. Your surgeon will discuss them with you before surgery.
- Bleeding or infection (uncommon)
- Change in voice or hoarseness, usually temporary, rarely permanent
- Low calcium level because of the parathyroid glands, usually temporary
- Fluid collection under the skin, or numbness around the incision, which usually settle on their own
- Need for thyroid hormone tablets after the operation, if the whole thyroid is removed
- Need to convert to open surgery in a small number of cases
Recovery and follow-up
Most patients stay in hospital for a short time after the operation, and the surgeon will tell you when you can go home. You can usually eat and walk soon after the operation. Light daily activity is resumed gradually; heavy exertion is avoided for the period your surgeon advises.
- You will be told how to care for the wounds and when to remove or review the stitches.
- The removed thyroid is examined in the laboratory (histopathology). The report decides whether any further treatment is needed.
- If the whole thyroid is removed, you will take a daily thyroid hormone tablet. Blood tests are repeated to set the right dose.
- Call the hospital or see a doctor at once if you notice breathlessness, increasing neck swelling, tingling around the mouth or fingers, or fever.
Endoscopic, open or robotic thyroid surgery – which one?
All three are accepted ways of removing the thyroid. Open surgery is the standard approach and is suitable for almost every patient, including large goitres and advanced cancers. Endoscopic surgery aims at a smaller or hidden scar in selected patients. Robotic thyroid surgery uses a robotic system for the same purpose. The best choice depends on your diagnosis, the size of the thyroid, your general health and your wishes.
Consult a thyroid surgeon in Varanasi
If you have a lump or swelling in the neck, a thyroid nodule, a thyroid cancer diagnosis, or you simply want a second opinion on thyroid surgery, you can meet Dr. Om Prakash Prajapati at Delta Hospital & Cancer Centre or the Thyroid, Endocrine & Breast Cancer Clinic in Varanasi. Patients from other cities and states in Purvanchal can also start with an online video consultation. Read more about thyroid care at Delta.
Related reading
This page gives general information and is not a substitute for a medical consultation. Please consult a doctor for advice about your own condition.
