Removal of one half of the thyroid gland is called a thyroid lobectomy. Importantly, all of the critical structures other than the thyroid are left behind and undamaged, including both parathyroid glands (the glands that control the calcium) and the nerves that provide movement (recurrent laryngeal nerve) and sensation and tightening (external branch of the superior laryngeal nerve) to the voice box. The lymph nodes along the side and beneath the thyroid gland are also examined during a thyroid lobectomy to make sure that they are not cancerous as well (called the level VI and VII lymph nodes/central compartment lymph nodes). Editors note: A thyroid lobectomy is generally not recommended when there are nodules (lumps) present in both sides of the thyroid gland (both thyroid lobes possessing nodules).
Thyroid Lobectomy basic facts:
- A very effective surgical treatment for small to intermediate size (up to 4 cm or 1.75 inch) papillary thyroid cancers
- Small cosmetic incision design
- Essentially little to no risk of hypoparathyroidism (low blood calcium)
- Outpatient surgical procedure
- Return to normal aerobic exercise activities and daily functions in 24 hours.
- No heavy lifting for three weeks
- Remaining thyroid tissue makes it easy to maintain normal thyroid hormone levels. Many patients may not even require a thyroid medication because the remaining thyroid tissue may produce adequate thyroid hormone for the body.
- The papillary and follicular thyroid cancers will not be effectively monitored by measuring Thyroglobulin levels (since the remaining normal thyroid gland will also make thyroglobulin).
- Only one nerve controlling voice box function is even at theoretical risk of injury.
- Thyroid lobectomy is a great operation to be performed by robotic thyroid surgery which leaves NO SCAR!
- A papillary thyroid cancer is less than 4cm and there is no evidence of abnormal lymph nodes on ultrasound or CAT scan
- The patient desires an easy method to maintain their thyroid hormone blood levels following surgery. (Some patients are concerned about their ability to adequately control their hormone levels and sense of well being when they are totally dependent upon taking thyroid hormone pills)
- The papillary thyroid cancer patient understands their thyroid cancer and accepts that the blood test for the blood marker for papillary thyroid cancer called thyroglobulin, will not be useful in their monitoring of their cancer since this protein is also produced by the remaining normal thyroid cells in the remaining thyroid tissue
- The thyroid cancer patient understands that radioactive iodine will not be used for the treatment of their cancer
- The thyroid cancer patient does not desire or accept radioactive iodine as a treatment option for their cancer. If lymph nodes are enlarged or show signs of cancer spread, they will be removed as well.