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Thyroid Surgery with Laparoscopic Surgery in Graphic Detail

The thyroid gland is located in the front of the neck and is fixed in front of the trachea by the pretracheal fascia. The thyroid gland is divided into the left and right lobes and the isthmus in the middle of them. The left and right lobes are located on both sides of the trachea, and the isthmus is in front of the trachea, equivalent to the 2nd to 4th tracheal cartilage. The thyroid gland is suspended from the cricoid cartilage by the suspensory ligaments at the medial side of the upper pole of the left and right lobes. Therefore, when swallowing, the thyroid gland also moves up and down with it.

I. Anatomy of the thyroid gland and its parts
1. Peritoneum of the thyroid gland
2. Thyroid arteries and veins
3. Thyroid lymphatic reflux
4. Thyroid nerves
5. Neck anatomy

Indications and contraindications for thyroid surgery
1. Simple goiter causing clinical symptoms
2. Simple thyroid gland enlarged significantly after puberty.
3. Nodular goiter accompanied by hyperthyroidism or with the possibility of malignancy
4. Thyroid cysts that cause respiratory distress by compressing the trachea.
5. Severe hyperthyroidism that has been treated with medication for 1 year without significant effect.

1. adolescents with mild symptoms
2. Elderly and weak, with important organ insufficiency, unable to tolerate surgery

Anatomy of the thyroid gland
Thyroid gland
Thyroid blood vessels
Thyroid lymphatic return
Thyroid nerves
Parathyroid glands

Muscles surrounding the thyroid gland: vastus cervicis, sternocleidomastoid, sternocleidomastoid, acromiocleidomastoid, sternocleidomastoid.

Subtotal thyroidectomy
Primary hyperthyroidism
nodular goiter secondary to hyperthyroidism
nodular goiter with multiple bilobar nodules
Multiple thyroid adenomas

V. Surgery and Precautions
Anaesthesia: general anaesthesia with tracheal intubation
Surgery: Subtotal thyroidectomy
Amount of gland to be removed: 10 grams retained
Operate gently and carefully, stop bleeding thoroughly, protect the thyroid gland, protect the parathyroid glands, avoid damaging the recurrent laryngeal nerve.

VI. Preoperative preparation
1. Preoperative visit (hand-washing nurse, visiting nurse and anaesthesiologist visit together): check the medical records, understand the patient's general condition, the size of the mass and the results of various examinations, understand whether the patient has any comorbidities (if there is a combination of cervical spondylosis or heart disease, the body position should be placed after intubation with general anaesthesia; if there is hyperthyroidism, the placement of the body position should be gently, the head tilted back, the angle of neck hyperextension should not be too large, and the end of the head should be adjusted downward by 10 degrees to prevent fracture), allergies and allergies. The patient should have a history of allergy, surgery and blood transfusion.

2. Strengthen psychological care: the nurse should patiently explain the patient's problems before the operation, introduce the purpose of the operation, method, anaesthesia and anaesthesia and operation position with easy-to-understand language, give the patient psychological guidance and appropriate health education to eliminate the patient's concerns, let the patient set up confidence, and actively cooperate with the operation. At the same time, patients were informed of the importance of fasting and water fasting. On the day of surgery, the nurses took the initiative to communicate with the patients before picking them up and introducing the environment of the operating theatre, and answered the patients' questions carefully and patiently.

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