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Thyroid Nodule Removal Surgery

Thyroid Nodule Removal Surgery

About thyroid surgery

Thyroid nodule removal surgery may use a lobectomy or a total thyroidectomy to remove a section or all of the thyroid containing the nodule.

In a lobectomy, the surgeon removes only the section — called a lobe — that contains the lump.

In a total thyroidectomy, the surgeon removes the entire thyroid. The incision will be in the neck, above the collarbone; the incision length depends on the size of the thyroid. The surgeon will close the incision in a way that limits scarring. The stitches will be under the skin and won't need to be removed. Thin strips of surgical tape called STERI-STRIPS, or a liquid bonding agent called DERMABOND, close the skin.

Watch the video below to learn more about thyroid surgery and the multidisciplinary team that will work with your child, including our surgeons and experts from CHOP's Pediatric Thyroid Center.

  • It Takes a Team

    N. Scott Adzick, MD: The expertise that's available here in the Pediatric Thyroid Center at CHOP is multiple, multiple layers, which, I think, lead to special care and special results. 

    Megan Lessig, MSN, CRNP: We all work very closely together--

    Goli Mostoufi-Moab, MD: --to make sure that we really come together as a team and give the best care that the patient really requires. 

    Bruce R. Pawel, MD: The disciplines include surgery, the surgeons who actually remove the tissue. 

    Anne Marie Cahill, MD: We have endocrinologists who are world-famous in what they do in terms of the-- all endocrine glands. Coupled with that we have a very good collaboration between endocrine and oncology. 

    Bruce R. Pawel, MD: Radiology. 

    N. Scott Adzick, MD: Every single operation is done with a pediatric anesthesiologist. 

    Bruce R. Pawel, MD: And pathology as well. 

    Megan Lessig, MSN, CRNP: Nursing is a very important component between disciplines. 

    Andrew J. Bauer, MD: It's kind of the single point of contact--

    Goli Mostoufi-Moab, MD: --in terms of getting all the information needed to have the patient evaluated in the Thyroid Center. 

    Megan Lessig, MSN, CRNP: And providing the patient with the education and the care coordination to facilitate the more difficult medical system. 

    N. Scott Adzick, MD: We have patients who are referred locally, regionally, nationally and even internationally, who want that sort of expertise for their children, but coming from such a distance leads to special needs for lodging and advice and financial support, in some cases. 

    Megan Lessig, MSN, CRNP: We're fortunate in this center to have a social worker involved in the care of these patients, which is very important so the patient is not only cared for in terms of what they need medically, but also what they need emotionally. 

    N. Scott Adzick, MD: For a child going through this process, we have access to child life support. The child life specialists provide expertise in many of the psychological aspects of going through an operation that a child and a family really need. 

    Andrew J. Bauer, MD: One of the advantages of where Children's Hospital of Philadelphia is located is that we're adjacent to the Hospital of the University of Pennsylvania. 

    N. Scott Adzick, MD: We work in partnership with them and can cull all their expertise, whether it be in pathology or other aspects of care that we can now apply to children with thyroid cancer. 

    Andrew J. Bauer, MD: And when the children are old enough, they're young adults, because we see kids up to age 23, which aren't really kids, they're young adults, but the transition of care then is easily set in place. 

    Megan Lessig, MSN, CRNP: It's very important for the patient and their family to be very involved during the entire process. 

    Bridget Ronca: The team was all really helpful in explaining it, getting us through it because we never experienced any of this before. 

    Phil Ronca: It would've been a lot more difficult to get through this if we didn't have the Thyroid Center supporting us. 

    Andrew J. Bauer, MD: They really need to understand the process and we encourage them to write down questions, to bring them in, and we go through them. We've gone through lists sometimes as long as 15 to 20 questions long. And that's what we want. We want them to read. We want them to be informed. 

    Bonnie Pierson: I did feel like as part of the team effort because it started off with Dr. Bauer diagnosing me, but then he gave me the options and all the doctors were willing to work with me, no matter what route I took. 

    Anne Marie Cahill, MD: The family and the patient provide a very important part of that team for us because they know their child best. The child knows themselves best. 

    Michelle Pierson: From the beginning to the end, when you have your first appointment all the way through the surgery, they seem to be very much all in communication and willing to communicate with you and back with your concerns. 

    Goli Mostoufi-Moab, MD: Even though there's a certain way to treat a disease, the patient is not a disease. The patient is a patient. 

    Bruce R. Pawel, MD: When I look in the microscope, it's not just looking at a piece of tissue. It's really bearing in mind that this is something that comes from an individual. It comes from a child. It comes from a child with a family. 

    Andrew J. Bauer, MD: The families inspire me and humble me and educate me and remind me that we don't have all the answers, but finding them is important. 

Transcript Transcript

After thyroid surgery

After surgery, your child will go to the recovery room for about an hour, then back to their regular hospital room. The head of their bed will be slightly raised for 24 hours.

Your child will get pain medicine through an intravenous (IV) line first, then by mouth once they begin eating and drinking. His doctor may order blood tests to check their calcium levels; your child may have to take thyroid medication or calcium after surgery.

Your child will usually be discharged 24 to 48 hours after thyroid surgery.

Follow-up care after surgery to remove thyroid nodules

You'll need to take your child back to their surgeon's office about two to three weeks after surgery for a follow-up appointment. They will also need to see an endocrinologist, who will continue to care for your child as an outpatient.

When to call the doctor

Please call your child's doctor's office (at Children's Hospital, call 215-590-2730) if:

  • You see any signs of infection at the incision site:
    • Swelling
    • Redness
    • Yellow or green drainage
    • Bleeding
    • Fever greater than 101.5°F
  • Your child has difficulty swallowing or breathing
  • Your child has numbness or tingling around his lips or fingertips
  • Your child's pain is not controlled by prescribed medicine
  • You have any questions or concerns
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