My standard technique of thyroidectomy is presented. This is a step-wise approach that is safe, effective and efficient. The technique, with contingency for possible roadblocks,  is as follows:

    1 – Skin incision
    2 – Elevation of skin flaps
    3 – Splitting of long strap muscles in the midline raphe
    4 – Horizontal division of sternothyroid muscle reflection of the divided ends
    5 – Identification of the trachea
    6 – Identification of the inferior parathyroid gland
    7 – Identification of the recurrent laryngeal nerve
    7 – Securing the superior pole vascular pedicle after identification of the external branch of the superior laryngeal nerve
    8 – Tracing the recurrent nerve to its insertion in the posterior aspect of the crico-thyroid joint
    9 – Identification and lateralization of the superior parathyroid gland
    10 – Dissection of the thyroid off the trachea
    11 – Securing the isthmus (if partial thyroidectomy is performed)
    12 – Hemostasis
    13 – Closure


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    Celestino Lombardi, Co-Chair
    Gregory W. Randolph, MD
    Bryan McIver, MD
    Jeremy Freeman, MD
    Ian J. Witterick, MD
    Ashok R. Shaha, MD
    Jatin P. Shah, MD