Lesson 1Selection of operative approach: hemithyroidectomy, total thyroidectomy, completion thyroidectomyThis lesson details criteria for hemithyroidectomy, total, or completion thyroidectomy, combining tumour traits, risks, past surgery, patient wishes, guidelines, and counselling on risks, benefits, and lifelong hormone follow-up.
Oncologic and benign disease indicationsRisk stratification and guideline useWhen to choose hemithyroidectomyIndications for total or completion surgeryShared decision making with patientsLesson 2Immediate postoperative monitoring: airway, hematoma recognition and management algorithmsThis lesson covers immediate post-thyroidectomy monitoring, airway checks, neck hematoma detection, standard protocols, escalation steps, and management algorithms for bedside or theatre interventions.
Postanesthesia airway assessment stepsNeck wound checks and early warning signsHematoma risk factors and preventionBedside decompression and emergency stepsCriteria for urgent return to the ORLesson 3Role and practical use of intraoperative nerve monitoring: indications, limitations, and alternativesThis lesson explores nerve monitoring setup, indications, electrode placement, stimulation methods, signal troubleshooting, EMG interpretation, limitations, and safe backups without monitoring.
Basic principles of nerve monitoringIndications and patient selectionEquipment setup and troubleshootingInterpreting EMG signals and alertsSurgery without monitoring: safe strategiesLesson 4Calcium and PTH monitoring protocols after thyroidectomy and initiation of thyroid hormone replacementThis lesson reviews calcium and PTH testing protocols post-thyroidectomy, hypocalcemia risks, calcium/vitamin D treatments, hormone start timing, and dosing by TSH and patient risk.
Timing of calcium and PTH measurementsRisk stratification for hypocalcemiaOral and IV calcium and vitamin D regimensInitiating levothyroxine after surgeryTSH targets and dose adjustment plansLesson 5Anaesthesia considerations and perioperative optimisation including anticoagulation managementThis lesson covers anaesthesia for thyroid surgery, airway assessment, intubation, comorbidity handling, anticoagulation adjustments, fluid/blood pressure goals, and post-op pain/nausea control.
Airway assessment and intubation planningManagement of comorbid conditionsAnticoagulation and antiplatelet adjustmentIntraoperative hemodynamic and fluid goalsPostoperative analgesia and nausea controlLesson 6Haemostasis techniques, use of energy devices, and management of problematic bleedingThis lesson focuses on precise haemostasis in thyroidectomy using ties, clips, energy devices safely near nerves/parathyroids, hematoma prevention, and handling brisk bleeding.
Vascular anatomy relevant to hemostasisSuture ligation and clip techniquesTypes and settings of energy devicesSafe use near nerves and parathyroidsAlgorithm for intraoperative bleedingLesson 7Identification, preservation, and autotransplantation of parathyroid glandsThis lesson explains finding and saving parathyroid glands in usual/ectopic spots, blood supply, avoiding damage, autotransplant criteria, methods, and post-op checks.
Recognizing normal and ectopic parathyroidsMaintaining parathyroid blood supplyWhen to perform autotransplantationAutotransplantation sites and techniqueAssessing postoperative parathyroid functionLesson 8Lymph node management: central compartment dissection indications and extentThis lesson reviews central neck dissection for thyroid cancer, boundaries, reasons, prophylactic vs therapeutic, steps, and protecting nerves/parathyroids.
Central compartment anatomy and nodal levelsOncologic indications for central neck dissectionProphylactic versus therapeutic dissectionTechnical steps and key landmarksProtecting nerves and parathyroid glandsLesson 9Management of common complications: hypocalcemia, vocal cord palsy, wound infection, and seromaThis lesson addresses early thyroidectomy issues like low calcium, vocal cord paralysis, infections, seromas, with detection, tests, treatments, counselling, and referrals.
Recognition and treatment of hypocalcemiaEvaluation of vocal cord dysfunctionPrevention and care of wound infectionSeroma prevention and aspiration techniquePatient education and follow‑up planningLesson 10Intraoperative strategy for recurrent laryngeal nerve identification and preservationThis lesson describes systematic recurrent laryngeal nerve identification, variants, dissection planes, capsule technique, scarred fields, reoperations, and injury responses.
Key anatomic landmarks of the RLNInferior, lateral, and superior approachesCapsular dissection and safe planesManaging scarring and reoperative fieldsHandling suspected nerve injury
