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Right Hemithyroidectomy

Positioning

  1. Patient Positioning
  2. Ultrasound Examination
  3. Draping

Exposure

  1. Make 5 cm Transverse Incision on Anterior Lower Neck
  2. Elevate Subplatysmal flaps Superiorly to the top of Thyroid Cartilage and Inferiorly to the Sternal Notch
  3. Insert Self-retaining Retractor over Microfoam tape and Incise investing layer Deep Cervical Fascia
  4. Retract SH and ST Muscles from Thyroid

Examination

  1. Isolate/Retract Right Superior Pole Vessels Away from the Larynx
  2. Check Right Vagus N. Signal
  3. Divide and Ligate Middle and Lower Pole Veins
  4. Identify/Preserve Right Superior and Inferior Parathyroid Glands

Preservation

  1. Develop Plane Beneath Thyroid, Identify RIGHT RLN using Monitor
  2. Follow Recurrent Laryngeal N. to  Cricothyroid Insertion
  3. Divide the Ligament of Berry

Isthmusectomy

  1. Isthmus Clamped and Tied Using Sequential Hemostats.
  2. Remove Specimen, Mark for Pathology

Stabilization

  1. Hemostasis of the Right Thyroid Bed
  2. PPV in Trendelenburg, Hemostasis
  3. Check signal Right Vagus N. and RLN

Closure

  1. 4-0 Vicryl to Reapproximate SH and ST
  2. Reapproximate Fascial Layers
  3. 5-0 Prolene Subcuticular to Close Skin
  4. Apply Dermabond and Remove Prolene