What is a Thyroid Goiter? Can Thyroid Goiters be Removed Without Scars?A thyoid goiter is simply an enlargment of the thyroid gland. Goiters typically grow over many years and can cause symptoms because of their size. And ov course, they can look bad because of the large lump in the throat as seen in these pictures. Over time, the growing thyroid gland goiter can cause compressive or obstructive symptoms such as swallowing or breathing difficulties, discomfort, irritations, dry cough, or even tenderness. When symptoms arise, the goiter should be removed and the operting robot is perfect for this--and it leaves you without a neck scar!
Enlargement of your thyroid gland into a goiter can be due to a single nodule or multiple thyroid nodules (multinodular goiter). Most goiters are benign enlargement of the thyroid gland, but there could be underlying cancer which is more difficult to diagnose as the size of the goiter increase. Although the fine needle aspiration (FNA) biopsy is still the gold standard workup for thyroid nodules, its accuracy declines as the size of the goiter increases. Therefore, once the goiter or the nodule is larger than 4cm, surgery is generally recommended.
Is Robotic Thyroid Surgery Your Best Option for Thyroid Goiter Removal?Robotic thyroid surgery is quickly becoming the preferred method of surgically removing a thyroid goiters. Unfortunately, this is a very advanced operation and is only performed by a few surgeons in the US (read more abour Dr Suh Here). Most thyroid goiters, regardless of whether they have many nodules or one big nodule, can be removed with the robot if the surgeon is skilled in this advanced technique. So before you have your goiter removed, make sure you ask what your options are related to the surgical removal of your thyroid goiter.
Robotic Thyroid Surgery for Single Large Nodules, or Multiple NodulesThere are several causes of thyroid goiter, and it can be divided into few categories: benign enlargement of one or more thyroid nodules, diffuse enlargement of the thyroid due to inflammation caused by autoimmune diseases (your own body’s antibodies attacking your thyroid gland) or underlying cancer.
Robotic thyroid surgery is perfect for benign, non-cancerous enlargement of thyroid glands due to thyroid nodules. These nodular goiters usually grow until they cause symptoms due to their compressive effect in a confined neck space where your airway and digestive tracks physically being pressed against. Surgery will be recommended for any symptoms or if any of the nodules grow over 4 cm. Also, if any of the nodules is overproducing thyroid hormone causing hyperthyroidism, surgery will also be recommended. Again, the operating robot can be the perfect way to remove these goiters so the patient has no neck scar whatsoever when the operation is done.
Robotic Thyroid Surgery for Auto-Immune Thyroid GoitersRobotic thyroid surgery is very good for goiters caused by autoimmune thyroid disease. These goiters can be further categorized as increased production of thyroid hormone (hyperthyroidism) due to antibody stimulation of the thyroid gland as seen in Graves disease or decreased function of the thyroid gland (hypothyroidism) due to a destruction of the gland by your body’s own antibody attack. This is commonly known as Hashimoto disease. Graves disease often leads to swelling and enlargement of the thyroid gland whereas in Hashimoto thyroid disease, it typically causes shrinkage and fibrosis of the thyroid gland. Like the benign thyroid nodular goiter, goiters caused by autoimmune thyroid disease can be perfect candidates for removal by robotic thyroid surgery.
Robotic Thyroid Surgery for Goiters due to Thyroid CancerRobotic thyroid surgery is perfect for many thyroid cancers. Although cancer incidence is relatively low in a multinodular goiter, FNA biopsy is suboptimal in ruling out thyroid cancer in multinodular goiter. Therefore, any nodules over 4cm or suspicious findings, surgery is generally recommended. We have an entire section of this large webiste dedicated to robotic surgery for thyroid cancer.
Indications for Robotic Thyroid Surgery for Thyroid Goiter Removal
- Single or multiple thyroid nodules (>4cm, symptoms, suspicious FNA findings, hyperfunctioning)
- Graves disease (enlargement, failed medical treatment of hyperthyroidism)
- Hashimoto disease (fibrotic changes and enlargement causing obstructive symptoms)
- Underlying cancer (FNA biopsy result)
Robotic Surgery for Thyroid Goiter: Your Best Choice!Robotic scarless thyroid surgery is an option for your goiter surgery, and it may be your best option. Good exposure of the gland so the surgeon can see all the vital structures and nerves, and adequate working space are important in surgery for goiters. Therefore, traditional surgery for goiters usually requires much larger skin incisions and muscle incisions which often leads to large scars, swelling in the neck, and prolonged healing time. This is all because goiters are typically very large. But all of this can be avoided with the operating robot.
Robotic Surgery Leaves no Scar on the NeckRobotic Scarless Thyroid surgery can prevent such large incisions and scars. Robotic scarless thyroid surgery, regardless of the size of the goiter, can be performed through the same four small incisions that are well hidden. In resecting a large thyroid goiter, a surgical technique must be capable of creating an adequate exposure for a good visualization, working space for an ideal mobilization, and careful dissection of goiter from surrounding tissue structures.
Sub-Sternal Goiters Certain large goiters may grow down to the chest and below/behind the sternal chest bone (referred to as a substernal goiter, or retro-sternal goiter). Substernal goiters that grow more than a few centimeters (an inch or so) below the sternum are not candidates for robotic thyroid surgery because the sternal bone is in the way. Most substernal goiters still need to be removed via traditional thyorid surgery where a large scar is placed in the neck, but check with Dr Suh, a CT scan may show that only a little of the goiter is under the sternum and thus scarless robotic thyroid surgery is still an option.
We have an entire page that discusses how to travel to Tampa to have Dr Suh perform your scarless thyroid operation.