A Total Left Hemithyroidectomy using the
Harmonic Scalpel (UltraCision® Harmonic Scalpel®)
Step 1
A cervical incision is made 2cm above the clavicles. Subcutaneous fat and the platysma muscle are divided under the line of the incision and dissected superiorly until the thyroid cartilage and inferiorly to the supra-sternal notch.
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Step 2
The fascia of the strap muscles is divided in the midline.
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Step 3
The left lobe is mobilised and retracted medially. The middle thyroid vein is divided using the curved shears.
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Step 4
The superior pole vessels (branches of the superior thyroid artery) are divided by the curved shears.
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Step 5
The external branch of the superior larygeal nerve (see arrow) is identified.
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Step 6
The inferior parathyroid gland is preserved together with its blood supply.
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Step 7
When the thyroid lobe is retracted medially, the recurrent laryngeal nerve (see arrow) can be clearly identified before beginning the dissection of the lobe.
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Step 8
The superior parathyroid gland is preserved together with its blood supply.
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Step 9
The thyroid gland is separated from the tracheal wall, with the inferior laryngeal nerve (see arrow) under direct vison.
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Step10
The isthmus is divided after the thyroid lobe has been separated from the tracheal wall.
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