Puntos clave en la cirugía de la glándula tiroides

2020 
The aim of this article is to achieve an account of the key surgical points in thyroid and parathyroid surgery that helps the surgeon to achieve safe interventions. A surgery is not enjoyed if the surgeon does not have full knowledge of the applied anatomy of the area to be operated on. In thyroid surgery, having a basic understanding of the embryology of both glands provides great help when it comes to dissection and surgical treatment. The position of the patient and the equipment that we must have before starting the surgical act is essential. Releasing the gland from its support systems: fascia, ligaments and vascular pedicles, effectively and through the correct dissection plane is a key aspect in the proper development of the surgery. The identification of the tubercle of Zuckerkandl indicates the crossroads between the inferior thyroid artery, the superior parathyroid gland and the recurrent nerve. We consider neuromonitoring of the recurrent nerve necessary, because except for the exception of a known non-recurrent recurrent nerve, the complexity in the location of this nerve cannot be determined a priori. The hemostatic instruments that we currently have require their routine use. Thorough knowledge of thyroid surgery makes it easier for the surgeon to perform any surgical treatment of the parathyroid glands.
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