Ten years ago, Keralite Dr Thomas Varughese introduced a revolutionary change in the surgical procedure to remove swellings in the thyroid gland. It was the demand placed by a young woman patient that compelled the doctor to think about a new technique.
The woman worked in a major IT company. Beautiful, unmarried and drawing a fat salary, her only drawback was an enlargement of the thyroid gland. The condition could be treated by surgery, but the chances of the scar of the incision remaining on the front portion of the neck even after several years held back the woman from giving consent to the procedure.
Finally, she approached Dr Thomas Varughese, the oncologist at Renai Medicity in Palarivattom, Ernakulam. The woman placed her only demand before the doctor – carry out the surgery but the scar should not be visible. This set the doctor thinking and he decided to take up the challenge.
Earlier, the swellings in thyroid gland were removed through an incision made on the front side of the neck. The doctor realized that he needed to find an out-of-the-box solution to the woman’s problem. A new procedure was soon created by the doctor and it is now known as the ‘Thomas technique in thyroid surgery’, which has earned the recognition of medical professionals around the world. The number of patients who have undergone the procedure over the last ten years has crossed 1,500.
Thyroid gland is the most important gland in human body as it produces hormones that control all our functions, including growth. Before birth, thyroid gland would be placed behind the tongue. But afterwards, it shifts to near the trachea.
Swellings can develop on the thyroid gland at any age. Most of the time, they are benign and so the doctors never advised an emergency surgery in the past. However, the scenario has now changed. “The size of the swellings will anyway increase. When they become too big, surgical removal has to be carried out,” says Dr Thomas Varughese.
The first thyroid surgery was conducted 130 years ago. The procedure was suggested by Kohr, a German doctor and it is being followed without much change even now. Among the safest of surgeries, removal of thyroid swelling has some drawbacks. During the surgery, damage might occur to the nerves enabling speech, vessels supplying blood to the thyroid gland and nerves controlling voice modulation. In olden days, the risk involved was 60 %, but the figure has fallen to 10 % now.
Another major issue regarding the surgery was that a scar on the neck would remain throughout the patient’s life. It was this problem that Dr Varughese solved for ever.
The Thomas technique
The technique devised by Dr Varughese takes into account the fact that the thyroid gland is not located at the front of the neck. “So what is the need to create an incision on the front of the neck for the surgery?” the doctor asked himself.
A series of thoughts along those lines led to the new surgical procedure. Dr Varughese finally found that a swelling of the thyroid gland on the right side of the neck could be removed by making an incision on the left side of the neck and vice versa. This was a path-breaking development in the field of thyroid surgery. Dr Varughese discovered the method for helping thyroid patients who undergo surgery to avoid displaying the scar of incision on the front portion of their neck.
The neck has a number of natural folds known as ‘Langer’s lines.’ Dr Varughese found that if the incision is made through these folds, the scars will not be visible after surgery. Over 1,500 patients suffering from thyroid swelling have already undergone surgery using this advance new technique so far. They include people of all ages, from an eight-year-old boy to an eighty-five-year-old woman.
