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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