Indications, types of surgery, risks, preparation and recovery — written by endocrine surgeons.
The thyroid is a butterfly-shaped endocrine gland at the front of the neck that produces hormones regulating the body's metabolism. Common thyroid conditions include thyroid nodules, goiter (toxic and non-toxic), thyroiditis, and thyroid cancer. Thyroidectomy — surgical removal of the thyroid — is the main treatment for many of these conditions.
Surgery is recommended when there is a clear medical indication — not every nodule needs an operation. Common indications include:
| Type | What is removed | Suited to |
|---|---|---|
| Lobectomy | One lobe (the side with the nodule) | Benign one-sided nodules or small low-risk cancer |
| Total thyroidectomy | Both lobes | Thyroid cancer, toxic goiter, large bilateral goiter |
| Near-total / subtotal | Almost all, leaving a small remnant | Selected cases of toxic goiter |
| + Neck dissection | Neck lymph nodes as well | Cancer with lymph node spread |
Open (conventional) thyroidectomy is the long-established standard, using a neck incision of about 4–8 cm. It is safe, gives clear exposure of key structures, and suits large or invasive tumors; its main drawback is a visible neck scar.
Endoscopic thyroidectomy hides the incision away from the neck — via the mouth, axilla or chest. Thailand is a world leader in these techniques, especially the transoral approach (TOETVA), which leaves no visible skin scar.
Explore every endoscopic thyroidectomy technique →
Thyroid surgery is very safe in expert hands, but as with any operation there are risks to be aware of:
Patients typically have a thyroid ultrasound, blood tests for thyroid hormone and calcium, laryngoscopy in some cases, and fasting before surgery per the anesthesia team. Those with hyperthyroidism may need hormone levels controlled beforehand.
Most patients stay in hospital about 1–2 days and can swallow normally soon after. Calcium and thyroid hormone are monitored; if the whole gland is removed, hormone replacement is prescribed, and follow-up on the pathology guides further treatment such as radioiodine in selected cancer cases.
Beyond the thyroid, endocrine surgeons also perform parathyroidectomy for hyperparathyroidism (causing high calcium, thin bones and kidney stones), adrenalectomy for functional and non-functional adrenal tumors, and surgery for neuroendocrine tumors (NET) of the pancreas and GI tract — all requiring specialized expertise.
Learn about TOETVA, the transoral technique pioneered in Thailand.
