SCAR-FREE TOTAL THYROIDECTOMY

Thanks to advanced endoscopic techniques, doctors at Nam Sai Gon International General Hospital successfully performed a scar-free total thyroidectomy via axillary-breast access for a 21-year-old female patient with long-standing hyperthyroidism.

Ms. L.T.N.M., 21 years old, had lived with hyperthyroidism for years. Despite achieving stable thyroid hormone levels, she continued to experience persistent fatigue, weakness, and insomnia, especially over the past year. Initially, she attributed the symptoms to stress from studies and exams, but even after resting, her condition didn’t improve. Moreover, the visibly enlarged thyroid gland began to affect her quality of life, prompting her to seek definitive surgical treatment.

Upon evaluation at the General Surgery Department, imaging results showed stable thyroid function but significantly enlarged gland lobes, with dimensions of 26×20×60 mm (left) and 25×17×58 mm (right).

Scar-Free Total Thyroidectomy

Wanting to avoid a visible neck scar, the patient discussed surgical options with the General Surgery team of Nam Sai Gon International General Hospital. The doctors proposed a minimally invasive endoscopic total thyroidectomy via axillary-breast approach, using a harmonic scalpel. This advanced technique helps prevent the development of large nodules that may compress the airway or progress to malignancy.

The surgery, led by Dr. Nguyen Trung Duong, MMed, Specialist Level I, was performed with support from experienced anesthesiologists and state-of-the-art endoscopic equipment. The operation lasted 90 minutes and was meticulously executed. The patient had no postoperative fever, no hoarseness, no signs of hypocalcemia, and no swelling. She recovered well and was discharged shortly after surgery.

This method offers excellent cosmetic results — leaving no visible scar on the neck — and allows for faster recovery and greater confidence for the patient. The same approach is also effective for diffuse goiter, thyroid nodules, hyperthyroidism, and even thyroid cancer.

“Traditional open thyroidectomy leaves a noticeable transverse neck scar, which can be a concern for many — especially young female patients”, said Dr. Nguyen Trung Duong, MMed, Specialist Level II. “Endoscopic thyroidectomy not only avoids scarring but also reduces the risk of intraoperative bleeding and transient postoperative hoarseness, especially when we use harmonic scalpels instead of conventional bipolar cautery”.

The integration of 3D endoscopic imaging further enhances surgical accuracy. This technology magnifies delicate anatomical structures, such as blood vessels and nerves, allowing surgeons to perform faster and safer procedures with reduced bleeding and shorter hospital stays.

Nam Sai Gon International General Hospital is expanding its range of advanced thyroid treatments, including axillary endoscopic surgery, harmonic scalpel dissection, and radiofrequency ablation — offering patients more personalized, effective options. The hospital also accepts both public health insurance and private health insurance, ensuring accessible care.

What Happens After A Total Thyroidectomy?

If only one lobe is removed, the remaining lobe can typically maintain hormone function. If the entire thyroid is removed, the patient will need lifelong thyroid hormone replacement therapy to prevent symptoms such as fatigue, weight changes, dry skin, or cold intolerance. In some cases, parathyroid glands (which regulate blood calcium) may be temporarily affected, requiring calcium supplementation until normal function resumes.

Most patients adjust well after thyroidectomy. While some weight gain is common, proper hormone therapy and healthy lifestyle adjustments help maintain balance. There is also a small risk of recurrence if only partial removal is done; hence, postoperative follow-up and hormone management are essential.

Dr. Duong’s advice for patients after thyroid surgery — including adhere to regular follow-up schedules, maintain a proper diet, and take prescribed medications consistently.

Thyroid Health Awareness & Prevention

Hyperthyroidism is a common endocrine disorder with potentially serious complications such as thyroid storm or heart failure. Early detection and treatment are key. However, if left undiagnosed or untreated until later stages, the risk of severe, acute complications increases significantly, making treatment more difficult and the prognosis worse.

Therefore, Dr. Nguyen Trung Duong, MMed, Specialist Level II strongly advises that people with symptoms like neck swelling, fatigue, unintentional weight loss, tremors, bulging eyes, or palpitations should seek evaluation at reputable hospitals with experienced endocrine and oncology specialists. 

Thyroid diseases can often be completely cured if detected early. Everyone should undergo annual check-ups, especially those with family history or symptoms of thyroid disorders. A healthy lifestyle — regular exercise, no smoking, no alcohol, and a balanced diet — also helps strengthen immunity and reduce disease risk.

Nam Sai Gon International General Hospital accepts both public health insurance and private health insurance.