‘No-scar’ surgery helps a 30-year-old woman get rid of enlarged thyroid

PUNE: To most patients, a scar-free surgery would be nothing less than a boon. Such surgeries, with aesthetically pleasing results, are no longer restricted to private hospitals, where the high costs may play a deterrent.

A team of doctors at the state-run Sassoon General Hospital used an endoscopic technique to remove an enlarged portion of the thyroid gland that was troubling a 30-year-old woman from a financially weak background. The procedure left no scar on her neck or anywhere on the body.

Using the body's natural opening, the surgeon made a small incision on the inner part of the lower lip and created a passage under the neck muscle to get to the diseased gland and insert the slender endoscopes to operate it.

"In open surgery of the thyroid, there is an unsightly transverse scar over the neck. In case of minimally invasive surgery, there are multiple small scars over the neck as well as under the armpit. Peroral endoscopic thyroidectomy surgery is the only technique in which there is no visible scar for the patient, with all benefits of conventional surgery," explained surgeon Padmasen Ranbagle.

The Peroral approach is the shortest route for endoscopic thyroidectomy. "Though the surgery is technically challenging, cosmetic results rendered to the patient along with all the usual surgical benefits are rewarding," said Ranbhagle, who is an associate professor at Sassoon Hospital attached B J Medical College.

In this particular case, the woman had started noticing a gradually increasing swelling over her neck over the last six months. She started developing heaviness and difficulty in swallowing. Upon investigations, she was diagnosed with thyroid goitre — an enlargement of the thyroid gland.

In the woman's case, the right lobe of the gland had enlarged with a 6.5cm cyst, about the size of a large lemon. The surgeons only cut down the swollen right lobe and isthmus without touching the laryngeal nerve, which is responsible for a person's voice.

Thyroid swellings are common among women. Post-surgery scar over the neck may seem unsightly as the neck is the most visible portion of the body. A visible scar may result in low self-confidence, causing many to avoid wearing certain articles of clothing or to forgo participating in social activities.

"No-scar thyroidectomy is a boon as there is no scarring post-surgery," said surgeon S S Pathan, a member of the team involved in the surgery.

Sharing the view, HoD of surgery V S Dube said, "This is the first of its kind surgery performed at Sassoon Hospital. The surgery is safe in expert hands. Uneventful postoperative period, early recovery and discharge, besides being scar-free, are the advantages."

"Peroral endoscopic thyroidectomy is a step towards achieving our motto of delivering quality health care. With available infrastructure and technical expertise, we are able to perform advanced surgeries benefiting patients immensely," said spine surgeon Ajay Chandanwale, dean of Sassoon General Hospital.

The woman underwent the surgery on October 11. "I am very surprised to see that there is no scar on the neck. My husband, who is a scrap vendor, is also happy," said the visibly pleased patient.