- mark and infiltrate with 20cc local
- Transverse neck incision with scalpel
- create flaps using scalpel +/- cautery
- use russian foreceps to open linea cervicalis
- Cautery create areolar plane between straps and thyroid
- Davey-Langenbach retraction to create plane
- Finger on thyroid to roll up and out
- start at superior pole and take superior thyroid artery vessels carefully with mccabe dissector
- once near cricothyroid membrane then go work on inferior pole
- identify nerve at cricothyroid membrane along with parathyroid
- inferior para usually in the thyrothymic ligament
- save the attachement at the cricothyroid membrane for last
- clip or tie off everything
- leave a ?drain in every case - remove POD#1
- close line with vicryl
- interrupted vicryl for platysma, vicryl for skin and perfect steris
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