The total thyroidectomy, when performed correctly, leaves minimal thyroid residue and has a very low risk of recurrence, even in malignancies.

When is reoperation necessary?

The main reasons that may lead to thyroid reoperation are:

1. Residual tissue
   A subtotal (not total) thyroidectomy was performed , and a significant remnant remained that enlarged over time.
2. Thyroid cancer recurrence
   Local recurrence of malignancy after incomplete removal in the first surgery.
3. Unremoved lymph node metastases
   Located in the central cervical field, but not removed during the initial surgery.

What used to happen before?

In the past, many surgeons avoided completely removing the gland for fear of injuring the recurrent laryngeal nerveresulting in tissue remaining near the nerve.

Today, with Neuromonitoringskilled surgeons can perform complete total thyroidectomy with minimal residual (<1%), thus minimizing the risk of future reoperation.

How is the need for reoperation prevented?

Prevention is based on proper preoperative diagnosis and assessment ::

• Cervical ultrasound for lymph node mapping
• Ultrasound-guided biopsy thyroid

Professor Mr. Psychogios is specialized in both ultrasound diagnosis, and surgical preparation, ensuring the appropriate approach for each patient.

Peculiarities of thyroid reoperation

The reoperation is technically more demanding because:

• There are scars and adhesions from the first surgery.
• Normal anatomy has been altered
• May have had prior radiotherapy with radioactive iodine

All of the above increase the risk of injury:

• of recurrent laryngeal nerve,
• of the parathyroid glands.

High-precision techniques

Professor Mr. Psychogios, specialized in thyroid and salivary gland surgery, applies:

• Continuous neurostimulation/neuromonitoring
  to protect the laryngeal and vagus nerves
• Optical magnification with surgical loupes
  for precise and minimally traumatic manipulations
• Parathyroid camera
  where indicated, to preserve the parathyroid glands

Thanks to these techniques, safety and effectiveness are significantly improved even in the most difficult revision procedures (revision thyroidectomy).