History of Thyroid Surgery

The histories of thyroid and parathyroid surgery offer interesting contrasts: in thyroid surgery, surgeons started to operate to relieve symptoms resulting from anatomic problems such as dislocation and compression of adjacent structures, while for the parathyroid, first physiologists studied the gland’s hormonal function and its interaction with kidney and bone and then the surgeons started to operate to relieve symptoms. Even with pronouncements against thyroid surgery, progress in surgery and medicine developed dramatically in the second half of the nineteenth century. Theodor Kocher has been universally and deservedly acclaimed as “the father of thyroid surgery”. In the last decades, a better surgical view, thanks to the magnification offered by new instruments, made the surgical procedure safer and the patient’s recovery easier. Conventional open surgery has been the standard surgical technique for almost a century. This initially involved a 10 cm transverse midline neck incision which, over the years, was greatly reduced to a standard 3–6 cm incision with the use of magnifying glasses to offer a better tridimensional view. Although this procedure provides excellent exposure, the risk of scar hypertrophy and the search for better cosmetic results have led to the development of minimally invasive techniques.