Surgery for Hyperthyroidism

For people with Graves’ disease or a toxic nodular thyroid, doctors may recommend a total thyroidectomy. This procedure requires general anesthesia and takes about two hours.

Your surgeon makes a small incision in the front of the neck and removes the entire thyroid gland. Doctors use minimally invasive surgical techniques to help reduce bleeding and trauma to the surrounding tissue. After the gland is removed, the incision is closed with dissolvable stitches.

You usually go home the same day or morning after surgery. You may experience slight discomfort in the neck. A sore throat may occur, but it usually subsides within two days. If it persists, call your doctor.

When the entire thyroid gland is removed, you must take a synthetic thyroid hormone called levothyroxine for the rest of your life. This medication is taken by mouth once a day, and most people are able to tolerate it well.

If you have a single toxic nodule in the thyroid, a doctor may recommend a lobectomy with isthmusectomy. This surgical approach is the same as with thyroidectomy, but only half of the thyroid is removed during this procedure.

Your thyroid is composed of a right and left lobe, and they are connected by a thin strip of tissue called the isthmus. In this procedure, your surgeon removes the lobe that contains the nodule, as well as the isthmus.

Care after surgery is identical to that of a thyroidectomy, except that you are not automatically given thyroid hormone replacement medications. Part of your thyroid remains after this procedure, and it may be able to produce sufficient thyroxine.

During follow-up visits, your endocrinologist determines whether medication is necessary by using blood testing to measure the level of thyroid-stimulating hormone, or TSH, which is a hormone made in the pituitary gland that signals the thyroid to increase hormone production.

Doctors at NYU Langone may remove all or part of the thyroid to treat hyperthyroidism using minimally invasive surgery to reduce scarring. Our surgeons can talk to you about the possibility or using one of these approaches if you are concerned about scarring.

Retroauricular Thyroid Surgery

Our surgeons may use a robotic-assisted retroauricular approach to perform thyroid lobectomy with isthmusectomy or thyroidectomy to treat hyperthyroidism. We make a small incision behind the ear to minimize scarring and use a surgical robot to help perform these procedures.

The robotic-assisted approach results in excellent visualization of the thyroid and surrounding structures and gives us the ability to perform the surgery with a hidden incision.

“Scarless” Thyroid Surgery

Our surgeons may perform a “scarless” procedure known as the transoral and submental technique (TOaST) to remove thyroid tissue to manage hyperthyroidism. For this surgical approach, we make a tiny incision concealed within the natural fold beneath the chin and behind the lower lip area in the mouth to remove the thyroid gland, a method that minimizes visible scarring. The scar in the mouth is not visible, and the incision on the chin is barely noticeable.