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Title
1. Introduction
2. Positioning / Ultrasound / Draping
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a. Positioning
b. Ultrasound Examination
c. Draping
3. Exposure
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a. Incision and Dissection Through Platysma
b. Elevate Subplatysmal Flaps
c. Protect Skin with Microfoam and Incise Deep Cervical Fascia
d. Retract Sternohyoid and Sternothyroid Muscles
4. Examination
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a. Retract Right Superior Pole Vessels Away from Larynx
b. Check Right Vagus Nerve Signal
c. Divide Middle and Lower Pole Veins
d. Identify and Preserve Right Inferior and Superior Parathyroid Glands
5. Preservation
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a. Identify Right Laryngeal Nerve
b. Follow Right Laryngeal Nerve to Cricothyroid Insertion
c. Divide the Ligament of Berry
6. Isthmusectomy
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a. Remove Specimen, Tie and Clamp Isthmus
7. Stabilization
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a. Check Vagus
b. Positive Pressure Ventilation in Trendelenburg
c. Homeostasis of Thyroid Bed
d. Second Positive Pressure Ventilation in Trendelenburg
8. Closure
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a. 4-0 Vicryl to Reapproximate Sternohyoid and Sternothyroid
b. Close Platysma
c. Approximate Subcutaneous Layer
d. 5-0 Prolene Subcuticular to Close Skin
e. Apply Dermabond
9. Post-op Remarks
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Right Hemithyroidectomy
TK Pandian
;
Roy Phitayakorn, MD
Massachusetts General Hospital
Tags:
General Surgery
Otolaryngology
Oncologic Surgery
Multidisciplinary Surgery
Main Text
Procedure Outline
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Authors
TK Pandian
Roy Phitayakorn, MD
Filmed At:
Massachusetts General Hospital
Article Information
Publication Date
12/3/2024
Article ID
21
Production ID
0096
Volume
2024
Issue
21
DOI
https://doi.org/10.24296/jomi/21