23 hour stay hemithyroidectomy

You have been scheduled to undergo a hemithyroidectomy operation by your surgeon. You are well enough to be placed on a 23-hour pathway. This leaflet tells you what to expect before and after your operation. You will have had a leaflet detailing the operation given to you. The following information supplements this.

What is the thyroid gland?

The thyroid gland is a butterfly shaped gland located in the front of the neck and consists of two lobes joined by a small bridge of thyroid tissue called the isthmus. These two lobes sit on either side of the windpipe.

The thyroid is an endocrine gland which produces two hormones, T3 and T4, which are secreted into the bloodstream. These act on the cells and tissues in the body to keep them functioning normally. Sometimes too much or too little of these hormones are produced and this can impact the normal bodily functions such as how fast the heart beats, how much one sweats, weight loss or gain.

What is a hemithyroidectomy?

A hemithyroidectomy is the removal of one of the lobes of the thyroid gland.

Before the operation

Prior to surgery, you will either be telephoned or seen face-to-face by the preoperative assessment clinic. This is to assess how fit you are for surgery and anaesthesia and to ensure you are in the best health prior to the operation.

During the assessment, your practitioner will review your medical history and medications. They will also measure your height and weight and take some swabs to check for MRSA and COVID-19.

Finally, they may request some additional tests; these may include an ECG, chest x-ray, a urine sample and some blood tests. You will, in due course, receive a letter telling you the date, location and time of your surgery. At this time, we will advise you to start arranging your own transport home from the hospital after surgery.

You will also be advised on when to have your last food and drink before the operation in your admission letter. Please remember to pack an overnight bag for your hospital admission and bring in any of your usual medication as well.

What to expect on the day

You will be admitted on the morning of the operation and reviewed by a registered nurse, your surgeon and anaesthetist who will talk you through the day and be able to answer any questions you have.

You may undergo a nasendoscopy before the operation, to allow the surgeon to assess your voice box. This involves putting a slim tube-like camera in through the nose to see the voice box while you are awake. Some numbing spray will be applied into the nose beforehand to make this comfortable. This procedure will take less than a minute to perform.

Recovery after the operation

You will wake up in the theatre recovery area with an oxygen mask on your face. The recovery nurse will look after you until you are awake and ready to go to the ward. You may have a sore throat, or pain around the neck. Your nursing team will ensure that your pain is well controlled with pain relief. Once you are able to eat and drink without feeling sick, you will be able to have a light meal and something to drink.

After the operation

You will stay in hospital till early the next morning for observation and recovery. The surgical team will review you the morning after your surgery to confirm you are well enough to go home. Prior to discharge, you will have a nasendoscopy procedure to assess for any injury to the vocal cords during surgery. We expect to discharge you that same morning. You will need to arrange transport to collect you by 10am on the morning after surgery.

Going home

After surgery, it is natural to feel tired, but most patients are able to return to their normal activities within a week. We would advise waiting two weeks before returning to work to ensure you are well recovered. We also recommend no sports or heavy lifting of any sort for at least three weeks. Your doctor will arrange an appointment to discuss the results of the surgery with you a few weeks after the operation.

Wound care

Your wound should be kept dry for seven days. After this, the dressing can be removed and you will be able to shower as normal. Be careful not to overly soak the wound and to dry it gently. Your surgeon will use dissolvable sutures or an invisible glue, this means that you will not need to have any sutures removed after surgery.

The wound can often feel lumpy in the first few weeks. Using daily sun protection with a high SPF (SPF 50) for at least two months can prevent the scar becoming darker in colour. When your wound has completely healed, you can gently massage it using your fingertips, with or without some cream / oil to improve the appearance of the scar.

What to look out for

Whilst most people will have an uncomplicated recovery following hemithyroidectomy, there are important things you need to look out for:

• If you notice any large swelling under the wound incision or difficulty breathing, you should immediately attend the nearest emergency department.
• If your wound becomes red, hot, painful or begins to discharge, you should seek medical advice from your GP or notify us by contacting the secretary for your doctor via the main hospital switchboard.
• If you experience muscle cramps, numbness or tingling of the fingers, toes or around the mouth, you should attend the nearest emergency department immediately.

Contacts/further information

• Addenbrooke’s day surgery unit: 01223 256330 or 01223 216545
• The Head and Neck secretary via switchboard: 01223 245151; ask for the operator and ask them to connect you to your consultant’s secretary

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.