How is hemostasis obtained in the thyroid bed in a thyroidectomy?

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

Answer

Obtaining hemostasis in the thyroid bed is imperative. This is best performed with selective bipolar cautery, especially in the vicinity of the recurrent laryngeal nerve. A thin layer of thrombin mesh may be applied to the superior aspect of the bed. The usage of drains is controversial and the authors do not feel that they are routinely necessary. Note that drain usage does not replace meticulous hemostasis nor prevent hematoma accumulation. If a large defect or void exists following thyroidectomy, especially in patients with large goiters, a suction drain may be placed. The neck is then closed in a layered fashion with special attention to a meticulous skin closure.

Thyroid lobectomy performed using the described technique.

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