Setup for an Open Total Thyroidectomy (Ivy Tech Community College, Indianapolis, IN)
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Open total thyroidectomy is a commonly performed endocrine surgery. Using a standardized protocol for back table and Mayo stand setup can improve surgical efficiency and boost patient safety. The protocol demonstrated in this educational video covers instrument arrangement, specialized equipment preparation, and safety considerations specific to thyroid surgery. The setup includes organization of forceps, specialized bipolar energy devices, clip appliers, nerve monitoring equipment, and self-retaining retractors. Key safety measures include dual towel protection layers, separation of toothed versus smooth instruments, and sharps management. This protocol provides surgical technology students with a comprehensive framework for thyroidectomy setup and reinforces the fundamental principles of patient safety and procedural efficiency.
Total thyroidectomy represents one of the most frequently performed endocrine surgical procedures, with approximately 150,000 thyroidectomies performed annually in the United States.1 Recent data indicate that thyroid surgery accounts for a significant proportion of endocrine surgical training.2,3 This procedure requires great care due to the anatomical complexity of the thyroid region, including proximity to critical structures such as the recurrent laryngeal nerve and parathyroid glands. Surgical technology students must develop proficiency in organizing instrumentation and supplies specific to thyroid procedures to ensure optimal surgical outcomes and minimize operative complications.
Additional barrier protection was achieved by placing a sterile towel beneath the instrument pan and the area set aside for sharps. Patient drapes were placed on the Mayo stand in order of use to facilitate efficient draping. Sharp forceps (toothed) and smooth forceps were separated and arranged along the side of the instrument pan; a Ferris Smith forceps was placed centrally between the two groups to serve as a visual divider and enable rapid identification. Specialized equipment for thyroid surgery includes bipolar electrosurgical forceps (for precise hemostasis near critical neurovascular structures), Ligaclip appliers, nerve monitoring equipment for recurrent laryngeal nerve identification, and self-retaining retractors. The initial (preoperative) surgical count must be performed collaboratively with a circulating nurse or other licensed professional, and must include sponges and sharps, such as electrocautery tips, sutures, and surgical blades. This setup protocol provides surgical technology students with a comprehensive framework for an open total thyroidectomy setup, addresses the requirements of thyroid surgery, and reinforces fundamental principles of asepsis which are applicable across surgical specialties. By providing a visual demonstration of proper techniques, educational videos can promote consistency and efficiency, and serve as reference materials for students preparing to enter clinical settings. Surgeon preference regarding specific instruments and equipment may vary, so surgical technologists must be adaptable while maintaining foundational setup principles.
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References
- Al-Qurayshi Z, Robins R, Hauch A, Randolph GW, Kandil E. Association of surgeon volume with outcomes and cost savings following thyroidectomy a national forecast. JAMA Otolaryngol Head Neck Surg. 2016;142(1). doi:10.1001/jamaoto.2015.2503
- Zarebczan B, McDonald R, Rajamanickam V, Leverson G, Chen H, Sippel RS. Training our future endocrine surgeons: a look at the endocrine surgery operative experience of U.S. surgical residents. Surgery. 2010;148(6). doi:10.1016/j.surg.2010.09.032
- Gimm O, Barczyński M, Mihai R, Raffaelli M. Training in endocrine surgery. Langenbecks Arch Surg. 2019;404(8). doi:10.1007/s00423-019-01828-4
Cite this article
Wiseman D. Setup for an open total thyroidectomy (Ivy Tech Community College, Indianapolis, IN). J Med Insight. 2026;2026(552). doi:10.24296/jomi/552
