A re-exploration of the thyroid is a major undertaking and requires considerable skill and experience. The most important factors for the surgeon are the preservation of the recurrent laryngeal nerves and the parathyroids. It is mandatory to check the vocal cords before the operation and the patient should be informed of the greater risk of complications compared with a first exploration. Nerve monitoring must be used. It is rare not to be able to identify the nerve and even in re-explorations nerve damage in our hands is less than 1%.
A picture demonstrating a re-do adherent recurrent laryngeal nerve - click to enlarge
This operation can be undertaken using the same approach as for a normal thyroidectomy, but Mr Lynn uses a lateral approach.This allows the thyroid and recurrent laryngeal nerve to be exposed from another angle. This is described in detail under 'Re-exploration of the Parathyroid' which uses a similar technique.