Background: Although total thyroidectomy has become the operation of choice in treatment of BMNG, it leads to permanent hypothyroidism which lead the patient to take a lifelong exogenous hormone replacement therapy, which involves daily administration of levothyroxine at a dose that must be in close follow-up in terms of thyroid hormone levels. In addition, reaching euthyroid status using hormone replacement therapy can be affected in  presence of other medical problems that interfere with absorption of the drug as mal-absorption syndrome. When all these are considered, there is a necessity of a novel method to avoid the occurrence of postoperative hypothyroidism.Methods: A case series prospective study carried out over 30 patients with benign thyroid disorders for whom total thyroidectomy is indicated to evaluate the capacity of auto-implanted thyroid tissue in achieving an euthyroid state without any need for life-long hormone replacement therapy. Postoperative Assessment consists of repeated thyroid function tests and thyroid scan with complementary SPECT/CT.Results: significant gradual increase in serum levels of T3 and T4 with corresponding decrease in TSH levels returning to normal levels 6-9 months postoperatively. Thyroid scan with complementary SPECT/CT was done for 15 patients to evaluate the functional capacity of the thyroid implant.  Among the 15 patients, 13 patients have functioning thyroid implant (success percent: 6.6%). whereas 2 patients show non functioning thyroid implant (failure percent: 13.3%).Conclusions: Thyroid Auto-transplantation following total thyroidectomy in benign thyroid disorders is an effective method to prevent postoperative hypothyroidism.

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Background: After achievement of parathyroid autotransplantation, thyroid autotransplantation was presented with goal of preventing or lessening severity of post-thyroidectomy hypothyroidism in noncompliant patients. Goal and objectives: In this research, we intended to evaluate efficacy of autotransplantation of thyroid tissue after total thyroidectomy (TT) in benign thyroid disorders to keep the patient euthyroid with no need for life long hormone replacement therapy. Studied cases and methods:The study included thirty patients with benign thyroid disorders for whom total thyroidectomy was done. Autotransplantation was done by excising an apparently healthy portion weighing about 2-5 gm from the resected thyroid gland after total thyroidectomy and slicing this portion into about 10 small fragments then inserting these fragments into pocket made in the sternomastoid muscle. Follow up process contained measurement of serum levels of T3, T4 and TSH and thyroid scanning by 99mTC-MIBI scintigraphy. Results: Serum calcium level following total thyroidectomy: 28 patients had normal serum calcium level (8.5mg/dl-10.5mg/dl) and only 2 patients developed hypocalcaemia. These 2 patients were advised to take oral calcium to correct hypocalcaemia with regular follow up. Conclusion: Thyroid autotransplantation after total thyroidectomy is effective way to avoid postoperative hypothyroidism in benign thyroid disorders.

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Background: One of the most invasive procedures in endocrine surgery is the thyroidectomy. When the procedure is carried out in the appropriate surgical settings, it is safe with little morbidity and zero fatality Objective: We aimed to visualize the RLN and parathyroid and confirm it by staining with Diluted gentian violet for safe total thyroidectomy. Patients and Methods: At Assiut University Hospital, a quasi-experimental study was conducted on primary (not recurring) complete thyroidectomy that was performed on 100 individuals with benign and malignant goitre diseases. The patients were divided into two groups: 50 cases were operated on using the diluted gentian violet spraying approach in group 1 (interventional group), and 50 cases were established using the traditional procedure in group 2 (control group). The perilobe and thyroid lobe were covered with diluted gentian rinse. The recurrent laryngeal nerve and parathyroids were discovered and assessed. Results: In all cases, the recurrent laryngeal nerve was left uncolored and remained white, while all other tissues were coloured blue. The blue stain was washed out and the parathyroid glands' natural yellow hue appeared within three minutes. The thyroid gland was washed out in about 15 minutes. Conclusion:A new method called diluted gentian violet spraying makes it possible to recognise both parathyroid glands and recurrent laryngeal nerves. This method is technically sound, reliable, and safe .