Dr. Stefano Spiezia performs surgeries as extramural freelance professional, he is credited with leading insurance companies (Previmedical, Generali, Fasi, etc.) at the Ruesch Clinic in Via Maria Cristina di Savoia 39, 80122 Naples ph. +390817178111, or at the Ruggiero Clinic, Via Corradino Biagi 18, 84013 Cava De ‘Tirreni SA, ph. +390864468611.
We operate all endocrine diseases with traditional or minimally invasive surgeries of thyroid, parathyroid, and lymph nodes also with the MIVAT/P video-assisted technique and all the pathologies of general surgical interest.
A traditional thyroid surgery is a relatively short operation and it requires a hospital stay of only one or two nights. The operating room staff (the surgeon, the anesthetist and the male nurse) will provide information on everything the surgical intervention involves.
If the patient suffers from hyperthyroidism, it will be necessary that in the weeks preceding the surgical intervention he takes (or continues to take) some medicines to control hormone levels. The operation will take less risk in its course if the thyroid hormone levels are normal. Before the operation will be carried out blood tests, a trunk x-ray and an electrocardiogram (ECG) to verify if the patient can sustain the surgical intervention. In some hospitals they provide also a pre-operative control of the vocal cords (laryngoscopy) for verifying their proper functioning and to assess the risk of injury during the operation. Once the need for surgical intervention has been established, the surgeon will explain to the patient the operation procedures. Only one lobe of the thyroid can be removed (lobectomy), almost it all (subtotal or almost total thyroidectomy) or totally (total thyroidectomy). In preparation for the surgical intervention, the patient will be asked to not eat after dinner the previous day. If the thyroid surgery takes place because the doctor suspects the presence of a thyroid tumor, the surgeon may also remove some lymph nodes near the thyroid. In this case the implications of the intervention can not be predicted, because the surgeon has to examine the lymph nodes during the operation to determine what to remove. The anesthetist will provide information about anaesthetic used: in a traditional surgery, the patient undergoes general anaesthesia to sleep during the course of the operation.
In the absence of complications, a total thyroidectomy should take less than two hours, a less extensive surgery may have a shorter duration. During the operation, the surgeon can use the neuromonitoring system to reduce the risk of injury of the nerves that control the voice. The system allows the surgeon to locate the nerves that run near the thyroid and also to verify their functioning during the surgical intervention, thus reducing the risk of injury.
Once awakened from the anaesthesia, it is likely that the patient is in a particular area in which the nursing staff can monitor him carefully until the complete awakening. The dripfeed, connected by tubes to the body, provides temporarily the necessary fluids until the patient can drink again, while other cannulas ensure draining the excess fluid in the area of the incision (drainage). All these tubes will be removed the same day or next day, according to the type of surgery and the speed of recovery. In the incision area on the neck there will be surgical glue, which will dissolve in a matter of weeks. The neck and throat will be inflamed and stiff for a few days, and therefore it will be administered a painkiller during and after the hospital stay. The pain decreases and then disappears within a few days. The patient in the postoperative care is controlled by laryngoscopic examination of the vocal cords to verify their proper functioning. The operating room staff will be committed to ensure the patient recovers shortly after the operation, possibly the following day. The patient will have to perform some exercises to overcome the stiffness of the neck, some with legs for the circulation and other breathing exercises to test the good lung function in order to avoid infections or postoperative clots. Usually the patient is discharged after one or two days from the operation. The neuromonitoring technique used during surgery by Dr. Spiezia at the Clinica Ruesch allows the drastic reduction of complications on the voice aesthetic result of the minimally invasive technique with video assisted access: less than 2 cm incision through which the thyroid lesion has been excised. The use of ultrasound is a critical time in the patient’s surgical evaluation: before, during and after surgery.
The neuromonitoring technique used during surgery by Dr. Spiezia at the Clinica Ruesch allows the drastic reduction of complications on the voice
Aesthetic result of the minimally invasive technique with video assisted access: less than 2 cm incision through which the thyroid lesion has been excised
The use of ultrasound is a critical time in the patient’s surgical evaluation: before, during and after surgery