Mayo stand and back table instruments for Thyroidectomy surgery setup
Clamping & Occluding
Cutting & Dissecting
Grasping & Holding
Retracting & Exposing
Suturing & Stapling
What to expect during Thyroidectomy
The surgeon will make an incision with a 15 blade across the neck. Dissection with cautery to reach the platysma. They will then retract with the skin hooks, and use the cautery more. Once deeper, a self retaining retractor will be placed.
They will then use blunt dissection with a pair of Metz to go through the fascia. A lot of doctors use the Harmonic scalpel now for these surgeries. The strap muscles will be divided with the Harmonic, and under this, lies the thyroid.
They will now spend a while dissecting some more, and may move to different retractors, such as small richardsons. Clips and ties may be used at this point to divide any structures.
Once the laryngeal nerve has been found and protected, the thyroid can then be removed. This is usually done with the Harmonic scalpel.
Once the thyroid is removed, a piece of thrombin mesh might be placed in the cavity to prevent any bleeding. Closure will occur in layers, and the skin may take a while to close, since the surgeon will be trying to avoid thick scarring.
Notes: Peanuts/kitners should always be available loaded on Kellys in case of bleeding. The thyroid specimen should be passed off immediately. Most surgeons use nerve monitoring during thyroid surgeries, so that will be one more cord you will need to throw off (they are pretty sharp, so be careful not to puncture through the drape).
2 thoughts on “Thyroidectomy”
That is actually a senn retractor not a freer skin hook on the mayo stand.
Good eye! The picture does show Senns and not Freer skin hooks. For shallow retracting in a delicate surgery like a thyroidectomy, either Senns or skin hooks could be used. It’ll mainly be up to the surgeon! Some may see skin hooks as too aggressive and opt for more of a dull option like the Senns.
When the setup was written, that is how the doctor performed it. The picture came later and was set up by a different tech for a different doctor. I do feel the setup should include both the Senns and Freer skin hooks even though only one is often used by the doctor. Setup updated!