11 November, 2020
Ten things to know when choosing your thyroid surgeon
Thyroid surgery is one of the most frequently performed surgeries in our hospitals. This is because morphological and functional alterations of the thyroid gland can have a prevalence of up to 67%, depending on geographical area. Despite being a common intervention, it is not an easy procedure. You need a deep anatomical knowledge of the neck region, delicacy and precision in treating the tissues to avoid collateral effects and possible complications. The biggest challenge facing the patient is choosing the most competent and prepared thyroid surgeon. For this reason, we believe that it is important to know some objective criteria to identify the ideal endocrine surgeon for you and to be able to make the decision. It is important who operates on you.
1.- OPINION OF OTHER PATIENTS: EMPATHY, CONFIDENCE, ACCESSIBILITY, REALISM…
The modern thyroid surgeon must be able to transmit the confidence necessary to face the vulnerability, uncertainty and defencelessness that an operation implies. To do this, they must be a firm but friendly and accessible person. They must know how to explain realistically what the possible side effects and complications of the surgery are: to explain things well but without alarming the patient.
“The modern thyroid surgeon must be able to transmit the confidence necessary to face the vulnerability, uncertainty and defencelessness that an operation entails”
2.- PROVEN YEARS OF EXPERIENCE
Surgical intervention is part inspiration and part technical. Years of experience give the surgeon the peace of mind of having a consolidated surgical skill, the reliability to work with responsibility and the disposition to resolve the possible contingencies that may appear during the operation. When choosing a thyroid surgeon, he or she must be an expert and specialist and demonstrate proven experience.
“Years of experience give the surgeon: tranquility, reliability and disposition”
3.- EXCLUSIVE DEDICATION TO THYROID SURGERY
Medicine and surgery have a wide range of fields, diseases and organs. It has been proven that the best clinical results are obtained with the specialisation of physicians in certain areas of knowledge. Endocrine and thyroid surgery would be one of the paradigms of this concept.
“It is proven that the best clinical results are obtained with the specialisation of physicians”
4.- THE HOSPITAL
There are different types of hospitals, from those that are local, with little complex pathology, to referral hospitals. In centres with a greater number of beds, services and specialities, patients have the possibility of being treated by professionals who are used to handling more complex cases. With thyroid and endocrine surgery, the complexity of the patient is usually synonymous with technical difficulties. So, it’s not just about choosing the ideal thyroid surgeon for you, you also have to consider the hospital, the facilities and the technology.
5.- MULTIDISCIPLINARY TEAM
Today, the approach to patients and their pathologies must be comprehensive. The operation is one more step in the healing process. To guarantee the success of the treatment, the surgeon must work integrated, and in harmony, with the different specialists who will intervene in the treatment. Surgery is not a definitive step, but it is often necessary and essential. The surgeon has to be the facilitator of this interaction between the various professionals who accompany the patient.
“To guarantee the success of thyroid surgery, the surgeon must work integrated in a multidisciplinary team of different specialists who will intervene in the treatment”
6.- KNOWLEDGE, INTEGRATION AND APPLICATION OF NEW TECHNOLOGIES
In the 21st century, when choosing the thyroid surgeon, a minimum expectation must be the technology used for endocrine surgery: microsurgical glasses (magnifying glasses that facilitate the identification of millimeter structures such as nerve bifurcations or parathyroid glands), neuro-monitoring of the recurrent laryngeal nerve (to reduce complications related to nerve injury), sealing-section instruments (to reduce bleeding complications) or intraoperative parathyroid angiography (to provide prognostic information on parathyroid function).
“Microsurgery glasses, neuro-monitoring of the recurrent laryngeal nerve, sealing-section instruments and intraoperative parathyroid angiography are part of the technology we must expect when choosing a thyroid surgeon”
7.- HIGH VOLUME OR VERY HIGH VOLUME SURGEONs
A large number of the thyroid surgeries performed in our country are performed by novice surgeons or those who are not specialists in endocrine surgery. They can be low-volume surgeons (they perform less than 100 thyroidectomies per year) or high-volume (they perform more than 100 thyroidectomies per year). However, there are also a few very high volume surgeons (they perform more than 200 thyroidectomies per year). These are the real experts in thyroid surgery.
“Depending on the number of surgeries performed per year, we can distinguish between low volume thyroid surgeons (<100 thyroidectomies), high volume (> 100 thyroidectomies) or very high volume (> 200 thyroidectomies)”
8.- COMPLEXITY OF INTERVENTIONS
When a surgeon faces patients with complex pathologies on a daily basis, they develop skills and mechanisms that are extremely useful when cases are much simpler. Although this claim lacks scientific evidence, it would seem logical, however, that if you are accustomed to the most difficult conditions, then you will have more ability when conditions are more favourable.
9.- RESULTS: PERCENTAGE OF COMPLICATIONS
When we talk about thyroid surgery, we must be aware that it is usually relatively young patients. For this type of patient, the aesthetic and functional result of the operation will mark their quality of life for years. When choosing the thyroid surgeon, we must demand that the surgical team demonstrate quality standards, verifiable results and, therefore, be experts.
10.- PARTICIPATION IN SCIENTIFIC SOCIETIES, STUDIES, PUBLICATIONS
Although this is not always the case, the thyroid surgeon who works in a referral hospital, and who is exclusively dedicated to Endocrine Surgery with years of experience, is usually recognized by the Professional Body to which they belong. And, apart from the professional duties that he or she performs, they will also participate in multicentre studies and be published in medical journals.