Thyroid Surgery

Principles and Practice

Madan Kapre, Madan Kapre, Madan Laxman Kapre, Madan Laxman Kapre

• Publisher: CRC Press
• Year: 2020
• Print ISBN: 9781138483781
• eBook ISBN: 9780429524462
• Topic: Medicine
• Subtopic: Endocrinology & Metabolism

This book will bridge a gap between the huge platform of literature available about thyroid surgery and the practical working reality. The pearls in techniques and surgical procedures will be exhaustively detailed with authors' individual experience enriched with quality photographs. It covers management of large/massive multinodular goiters which are the hall mark of Indian Thyroids. However, the emphasis will be more on applying this knowledge to a given patient and would largely revolve around this theme. It aims to provide a take home message in controversial areas and is a ready reference to all interested in learning science and craftsmanship of thyroid surgery.

Key Features

• Covers all topics comprehensively with a practical approach
• Inclusion of guidelines adds value to the content
• Discusses all investigatory modalities
• Consists of useful surgical tips with exhaustive operating photography
• Features large anatomical illustrations with cadaveric dissections

Chapter 1

History and Evolution of Thyroid Surgery

Cheerag Patel and Subhaschandra Shetty

Contents

Introduction

The History of Goiter

The History of the Thyroid and Parathyroid Hormones

The History of Surgery and of Surgical Instruments

The History of Thyroid Surgery

Future Directions

References

Introduction

It was Sir Winston Churchill who professed that:

“Those who fail to learn from history are doomed to repeat it.”

This expression serves as an important reminder that as progress is made, it is of paramount importance that we acknowledge and appreciate the history that has brought us to the present. In modern day, thyroid surgery is commonly practiced throughout the world for a variety of pathological conditions. However, the history of thyroid surgery has been wrought with mortality, trepidation, and discouragement. In this first chapter, we explore this history in further detail so that we may duly appreciate the serendipitous discoveries, tenacious perseverance, and unfortunate mortalities that helped to pave the path to the operations that thyroid surgeons, all across the world, perform today.

The History of Goiter

The enlargement of the thyroid gland is a pathological phenomenon that has attracted physician and surgeon fascination throughout humanity’s history.

As shown in Table 1.1, in around 2600 bc, the ancient Chinese were some of the first to describe thyroid enlargement and its treatment with seaweed [1]. Since this early reference, humanity’s understanding of the thyroid gland in both its normal function and in disease has evolved constantly, with historic milestones marking groundbreaking discoveries and landmark achievements.

Table 1.1 A brief timeline of the history of goiter and our understanding of it
Time	Description
2600 bc	Goiter is known in China—treated with burnt sponge, seaweed, and animal thyroid.
1400 bc–400 ad	Ayurvedic (traditional Indian) medicine in India provides detailed descriptions of galaganda (goiter)
460 bc–375 bc	“…when glands of the neck become diseased themselves, they become tubercular and produce struma…” –De Glandulis, Hippocrates
23 bc–79 ad	“…Only men and swine are subject to swellings of the throat, which are mostly caused by the noxious quality of the water they drink…” –Gaius Plinius Secundus of Pliny
130–210 ad	Galen of Pergamon describes “mutism” and “semi-mutism” as complications of (thyroid) surgery by way of scraping with a fingernail, “tubercular” nodes.
340 ad	Ko-Hung, famous Chinese alchemist, recommends seaweed for treatment of goiter for people living in mountainous regions.
550 ad	Aëtius of Amida describes exophthalmic goiter and recognizes the importance of preservation of the vocal nerves (recurrent laryngeal nerve) for phonation.
∼950–960 ad	Abu al-Qasim al-Zahrawi (Albucasis)—considered to be the greatest surgeon of the middle ages—first describes the thyroidectomy procedure and needle biopsies for goiter.
1170 ad	Roger of Palermo describes treatment of goiter with ashes of sponges and seaweed.
∼1250 ad	The Bamberg Surgery (surgical textbook) provides a detailed description of surgical thyroidectomy.
1475 ad	Chinese physician Wang Hei describes treatment of goiter with minced/powdered animal thyroid.
1500 ad	Leonardo da Vinci first illustrates the thyroid gland.
∼1540 ad	Bartholomew Eustachius first describes the isthmus of the thyroid gland.
1543 ad	Andreas Vesalius first provides anatomic description and illustration of the thyroid gland.
∼1650 ad	Thomas Wharton provides the modern name, thyroid, after the shape of an ancient Greek shield.
1811 ad	Bernard Courtois discovers iodine.
1820 ad	Jean Francois Coindet describes iodine deficiency as the cause for goiter and begins treatment with iodine.
1829 ad	J. G. A. Lugol recommends aqueous iodine for the treatment of goiter.
1831 ad	Francisco Freire-Allemao (Brazil) proposes iodine prophylaxis to prevent goiter on a government administered, public health basis.
1835 ad	Robert Graves describes a syndrome of palpitations, goiter, and exophthalmos in three women.
1862 ad	Armand Trousseau introduces the term Graves’ disease.
1883 ad	Emil Theodor Kocher describes myxedema as a complication of total thyroidectomy.
1909 ad	Emil Theodor Kocher—considered the father of modern thyroid surgery—receives the Nobel Prize for his work on thyroid...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Preface
• Acknowledgments
• Editor
• Contributors
• Introduction
• Chapter 1: History and Evolution of Thyroid Surgery
• Chapter 2: Surgical Anatomy of the Thyroid
• Chapter 3: Clinical Assessment of the Thyroid Nodule
• Chapter 4: Imaging of the Thyroid
• Chapter 5: Pathology of the Thyroid
• Chapter 6: Medical Management of Thyroid Disorders
• Chapter 7: Anesthesia for Thyroid Surgery
• Chapter 8: Safe Thyroidectomy
• Chapter 9: Surgery for Multinodular Goiter
• Chapter 10: Management of Retrosternal Goiter
• Chapter 11: Remote Access Endoscopic and Robotic Thyroidectomy
• Chapter 12: Robotic Thyroidectomy
• Chapter 13: Intra-Operative Neural Monitoring
• Chapter 14: Surgical Management of Differentiated Thyroid Cancers
• Chapter 15: Management of Nodal Metastasis in Thyroid Cancer
• Chapter 16: Complications of Thyroid Surgery
• Chapter 17: Locally Advanced Thyroid Cancer
• Chapter 18: Surgical Management of Medullary Thyroid Cancers
• Chapter 19: Surgical Management of Anaplastic Thyroid Cancers
• Chapter 20: Post-Treatment Surveillance of Thyroid Cancer
• Chapter 21: Applications of Radioisotopes in the Diagnosis and Treatment of Thyroid Disorders
• Chapter 22: Systemic Therapy (Targeted Therapy and Immunotherapy) for Thyroid Cancers
• Chapter 23: Surgical Management of Parathyroid Disorders
• Chapter 24: Pediatric Thyroid Surgery
• Index