Principles in Thyroid Surgery

There are a number of chapters in this text devoted to specific thyroid surgical approaches, ranging from minimally invasive to extracervical, robotic, and even transoral approaches (see Chapter 32, Robotic and Extra Cervical Approaches to the Thyroid and Parathyroid Glands and Chapter 34, Minimally Invasive Video-Assisted Thyroidectomy). In this chapter, we review when to perform thyroid surgery, the extent of surgery recommended, and the basic technical principles in standard thyroid surgery; the basic principles are, to some degree, applicable to all forms of thyroid surgery. Standard open thyroid surgery may be considered the basic starting point for all thyroid surgeons; familiarity with these surgical anatomic principles is an essential first step necessary for other less routine surgical approaches.