What is the history of thyroidectomy?

Updated: May 08, 2018
  • Author: Neerav Goyal, MD, MPH; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

The thyroid gland has been described throughout history but was first so named by the Romans for being a "shield-shaped" gland. Not only were thyroid masses mentioned in the literature throughout the 12th and 13th century, but in 1170 Robert Frugardi described the extirpation of a goiter. Thyroid surgery was undertaken well before thyroid gland physiology was understood. The procedures were often fraught with complications, including massive hemorrhage, infection, and injury to surrounding structures, all of which were associated with morbidity and mortality rates of nearly 40%.

Even in the 19th century, thyroid surgery was considered barbaric, described by Samuel Gross as "horrid butchery," and banned by the French medical society due to its high mortality. As technology improved and with the advent of aseptic technique, mortalities associated with these surgeries decreased. [1] During the 1850s, operations on the thyroid gland were undertaken via longitudinal, oblique, or vertical neck incisions. Jules Boeckel of Strasbourg introduced the collar incision to thyroid surgery in 1880, and this approach was popularized by Theodore Kocher. Theodor Kocher, whose own reported mortality rate for thyroidectomy dropped to 1%, was awarded the Nobel Prize in 1909 for his advancement of thyroid surgery in the late 19th century. [2, 3]

The surgical technique of thyroidectomy, as well as adjunct technology, continued to advance. Most recently, various new instruments (ie, harmonic technology) and approaches including video-assisted thyroidectomy and robot-assisted thyroidectomy have emerged. This chapter discusses the preoperative evaluation, intraoperative considerations, surgical technique(s), and postoperative concerns for patients undergoing thyroidectomy.


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