• WIPER  (wash hands, introduce yourself, permission, expose patient, reposition)

  • Ask if the patient is happy to see you


  • Check what the patient understands so far

  • What symptoms are they having and what treatments have they tried so far

  • Offer options including surgery and alternatives

  • Ask if they would like to know more about the operation

  • Ask permission to take consent

  • Explain you will outline the procedure, alternatives, risks and benefits, recovery time.

  • ‘If at any point you have any questions feel free to interrupt me, but I’ll also ask you afterwards if you have any questions’


  • Explain procedure

  • Draw diagram

  • Explain alternatives

  • Intended benefits

  • Potential risks and complications

    • With any operation, risk of bleeding, infection, pain, risk of GA – anaesthetist will be able to go through in more detail. See General Risks below

    • Also specific risks associated with this operation. 

      • Need for drain

      • Recurrent laryngeal nerve injury leading to voice change – hoarseness or difficulty singing high notes (temporary or permanent)

      • Low calcium levels (temporary or permanent) – if total or completion thyroidectomy

      • Low residual thyroid function requiring oral replacement (definite replacement required with total or completion thyroidectomy)

      • Haematoma

      • Return to theatre

      • Rare risk of tracheostomy with total hemithyroidectomy if bilateral recurrent laryngeal nerve injury

    • Individual risks to patient


Post op

  • Most likely to be day case procedure/overnight stay

  • Total/completion – will need to stay in for blood tests

  • May have a drain – this would be removed later that day/next day

  • Important not to do heavy lifting

  • Time off work – give sick note for 2 weeks

  • Contact department/attend A&E if: Increasing difficulty breathing, neck swelling, worsening pins and needles and/or cramp, fever, pain not responding to analgesics

Follow up advice

  • See back in clinic in 2-3 weeks with histology


  • Summarise consultation

  • Offer opportunity to ask questions

  • Offer patient information leaflet

  • Thank patient, wash hands and close

General Risks

  • Bleeding and bruising

  • Infection

  • Pain

  • Scar

  • Risk of general anaesthesia

  • Further surgery

  • Return to theatre

  • Recurrence

  • Suboptimal outcome

  • Numbness

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