Thyroidectomy for Toxic Goitre
Object number@MKZ
TitleThyroidectomy for Toxic Goitre
Creator Robert Wilson (1880-1940) Matthews (Artist)
DescriptionThirteen pencil drawings illustrating the steps of a thyroidectomy for toxic goitre, by R. W. Matthews dated 1939.
1. The line of the incision. A piece of silkworm gut laid across the neck helps in choice of a suitable line, and gentle pressure for a few moments leaves a transient impression which serves as a guide.
2/3. Retraction of flaps of skin and platysma with Joll’s retractor. The sternohyoid and sterno-thyroid muscles are being separated from the midline.
4. Ligation and division of the middle thyroid vein. Application of forceps to the surface of the gland is avoided as far as possible since a vascular goitre is apt to tear. The lobes are retracted by finger pressure over gauze, and this also serves to control bleeding points on the surface of the gland.
5. Ligation of the right superior thyroid vessels. A second ligation is applied to the retained stump to reduce the risk of ‘slipping’.
6. Ligation in continuity of inferior thyroid artery. In vascular and toxic goitres both arteries are tied, medial to the carotid sheath and well away from the recurrent nerve.
7. Ligation and division of the inferior thyroid veins.
8. Division of isthmus after complete mobilisation of both lobes.
9. Resection of the right lobe. By conserving the postero-medial portion of each lobe there is little danger of damaging or of removing the parathyroid glands.
10. Showing the position of, average amount, and suture of the remaining portion of each lobe. The amount of thyroid tissue left on each side is approximately equal to one third of a normal lobe, more or less being conserved according to the degree of hyperplasia of the gland.
11. Showing the position of drains and sutures of the depressor muscles.
12/13. Method of closure of wound. Platysma repaired by interrupted sutures and the skin closed by Michael clips.
Production date accurate 1939
Object nameThyroidectomy
Object categoryAnatomical, artwork
MaterialPaper
TechniqueDrawing
Dimensions
- Height: 34 cm
Width: 34 cm