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Thyroid Surgery Operative Checklist THYROID SURGERY OPERATIVE CHECKLIST (THYROID SYNOPTIC OPERATIVE REPORT TEMPLATE) Electronic version available on the BC SON website: http://www.bccancer.bc.ca/HPI/SON/ For a case that requires concurrent thyroid c. Benign- Goiter or Cyst 10. Adjunctive Surgical Techniques/ 14. Site of Gross Residual Cancer f. Visualized abnormal/enlarged and parathyroid surgery, please answer d. Benign- Graves Disease or Technology Utilized Present After Operation (indicate if biopsied/confirmed by questions 1 – 23 (below) and then complete Hyperthyroidism (Select all that apply) (Select all that apply) frozen section) and partially removed the Parathyroid Surgery Operative Checklist e. Inadequate FNA Biopsy(s) a. Monopolar electrocautery a. Right recurrent laryngeal nerve g. Visualized abnormal/enlarged (back of card). f. Other (please specify) b. Bipolar electrocautery b. Right esophagus (indicate if biopsied/confirmed by c. Electrothermal vessel sealing device c. Right trachea frozen section) and autotransplanted TM A. PREOPERATIVE DETAILS 6. If Thyroid Reoperation (Ligasure or equivalent) d. Right larynx h. Not identified (Select All That Apply) d. Ultrasonic vessel sealing device e. Left recurrent laryngeal nerve 1. Clinical Preamble - Dictate as a. Not applicable (Harmonic ScalpelTM or equivalent) f. Left esophagus 20. Destination and Marking of appropriate. May include details such as b. Completion thyroid lobectomy e. Recurrent laryngeal nerve g. Left trachea Parathyroid Autotransplantation patient marking, antibiotics, DVT, c. Removal central neck cancer monitoring h. Left larynx (Select all that apply) prophylaxis, etc. recurrence or persistence f. Loupes (magnifying glasses) i. Other (please specify) a. Not applicable d. Removal lateral neck cancer g. Robotics b. Right sternocleidomastoid muscle 2. Preoperative Fine Needle Aspiration recurrence or persistence h. Video assistance 15. Recurrent Laryngeal Nerve c. Right forearm (FNA) Biopsy? e. Removal central neck benign disease i. Intraoperative ultrasound Management d. Left sternocleidomastoid muscle a. Yes, image guided recurrence j. Parathyroid cryopreservation a. Right identified/preserved e. Left forearm b. Yes, not image guided f. Other (please specify) k. Other (please specify) b. Right identified/intentionally resected f. Other (please specify) c. No (go to question 5) c. Right identified /injured g. Location marked with clips 7. For Thyroid Cancer Diagnosis Only: 11. Operation Performed d. Right not identified h. Location marked with suture 3. Was the Bethesda System For Preoperative Clinical Extent of (Select all that apply) e. Left identified/preserved i. Location not marked Reporting Thyroid Cytopathology Disease Documented a. Right thyroid lobectomy f. Left identified/intentionally resected Employed? (Select all that apply) b. Right subtotal thyroidectomy g. Left identified /injured 21. Management of Central a. Yes a. Not applicable c. Right central neck dissection h. Left not identified Compartment Neck Lymph Nodes b. No b. Local (limited to thyroid or thyroid d. Right lateral neck dissection i. Not applicable (Levels VI-VII) surgical bed for reoperation) e. Left thyroid lobectomy a. Right Central Neck Dissection 4. What Was the Preoperative c. Regional (central neck lymph nodes) f. Left subtotal thyroidectomy 16. Right Superior Parathyroid Gland b. Left Central Neck Dissection Cytopathological Diagnosis? d. Regional (lateral neck lymph nodes) g. Left central neck dissection Management (select from options below) c. Bilateral Central Neck Dissection a. Non diagnostic or unsatisfactory e. Distant metastasis h. Left lateral neck dissection 17. Right Inferior Parathyroid Gland d. No Central Neck Dissection b. Benign i. Total or near total thyroidectomy Management (select from options below) c. Atypia of undetermined significance j. Isthmusectomy 18. Left Superior Parathyroid Gland B. OPERATIVE DETAILS If lateral neck dissection carried out, please or follicular lesion of undetermined k. Other (please specify) Management (select from options below) complete Lateral Neck Dissection Checklist - significance 8. Opening Narrative - May include 19. Left Inferior Parathyroid Gland SEE QUESTION 1 (BACK OF CARD) d. Follicular neoplasm or suspicious for a details such as incision type, flap If no thyroid/central neck dissection carried Management (select from options below) follicular neoplasm creation, etc. out, please complete Lateral Neck Dissection e. Suspicious for malignancy - 22. Frozen Sections Carried Out During Checklist (BACK OF CARD) Papillory Carcinoma 9. Location of Lesion(s)/Nodule(s) of a. Not applicable the Operation? f. Suspicious for malignancy - Interest b. Visualized normal (indicate if biopsied/ a. No Medullary Carcinoma (Select all that apply) 12. Gross Extrathyroidal Cancer confirmed by frozen section) and left in b. Yes g. Suspicious for malignancy - a. Right lobe +/- right central neck Extension Appreciated During situ c. What was frozen section diagnosis? Other (please specify) b. Right lateral neck Operation c. Visualized normal (indicate if biopsied/ List all diagnoses h. Malignant - Papillary Carcinoma c. Right superior mediastinum a. Yes or probable confirmed by frozen section) and i. Malignant - Medullary Carcinoma (i.e. below level of clavicle) b. No (go to question 15) removed 23. Additional Operative Details and j. Malignant - Other (please specify) d. Left lobe +/- left central neck c. Not applicable d. Visualized normal (indicate if biopsied/ Closure Narrative k. Other (please specify) e. Left lateral neck confirmed by frozen section) and May include details such as f. Left superior mediastinum 13. Gross Residual Cancer Present autotransplanted management of superior laryngeal 5. Primary Surgical Indication (ie. below level of clavicle) After Operation e. Visualized abnormal/enlarged (indicate nerve, sternotomy for goitre, drain a. FNA biopsy indeterminate or g. Both lobes +/- central neck a. Yes or probable if biopsied/confirmed by frozen section) utilization, operative blood loss, sponge suspicious for cancer h. Isthmus +/- pyramidal lobe b. No and removed and instrument counts etc. b. Malignancy- Papilla Carcinoma or other i. No specific nodule or lesion ©BC SON 2015 LATERAL NECK DISSECTION OPERATIVE CHECKLIST PARATHYROID SURGERY OPERATIVE CHECKLIST (LATERAL NECK DISSECTION SYNOPTIC OPERATIVE REPORT TEMPLATE) (PARATHYROID SYNOPTIC OPERATIVE REPORT TEMPLATE) 1. Reoperative Lateral Neck Dissection For a case that requires concurrent parathyroid and d. Total parathyroidectomy a. Visualized normal (indicate if biopsied/confirmed by a. Yes thyroid surgery, please answer questions 1–23 (below) e. Parathyroid cryopreservation frozen section) and left in situ b. No and then complete the Thyroid Surgery Operative f. Thymectomy b. Visualized abnormal (indicate if biopsied/confirmed by Checklist (back of card). g. Partial or total thyroidectomy (complete Thyroid frozen section) and partially removed 2. Management of Lateral Neck Lymph Nodes Surgery Checklist on back of card if this was carried c. Visualized abnormal (indicate if biopsied/confirmed by A. PREOPERATIVE DETAILS (Levels I-V) out) frozen section) and completely removed h. Other (please specify) (Select all that apply) 1. Clinical Preamble - Dictate as appropriate. May d. Visualised abnormal (indicate if biopsied/confirmed by a. Right lateral neck dissection include details such as marking, antibiotics, DVT QUESTIONS 8-11 SELECT FROM OPTIONS BELOW frozen section) and left in situ b. Left lateral neck dissection prophylaxis, etc. e. Not identified c. Bilateral lateral neck dissections 8. RIGHT SUPERIOR Parathyroid Evaluation 2. Surgical Indication/Preoperative Diagnosis 9. RIGHT INFERIOR Parathyroid Evaluation 20. Destination and Marking of Parathyroid 3. Lateral Neck Lymph Node Levels Dissected a. Primary Hyperparathyroidism - sporadic 10. LEFT SUPERIOR Parathyroid Evaluation Autotransplantation (select all that apply) (Select all that apply) 11. LEFT INFERIOR Parathyroid Evaluation b. Primary Hyperparathyroidism - inherited/familial a. Not applicable g. Location marked with clips a. I right f. I left c. Primary Hyperparathyroidism - lithium related b. Right forearm h. Location marked with suture b. II right g. II left d. Secondary Hyperparathyroidism a. Normal c. Explored/not identified c. Left forearm i. Other (please specify) c. III right h. III left e. Tertiary Hyperparathyroidism b. Abnormal d. Not explored/not identified d. Left sternocleidomastoid muscle d. IV right i. IV left f. Calciphytaxis e. Right sternocleidomastoid muscle e. V right j. V left g. Other (please specify) QUESTIONS 12-15 SELECT FROM TYPE A-G* BELOW f. Other (please specify) 12. RIGHT SUPERIOR Parathyroid Location 21. Adjunctive Surgical Techniques/Technology 4. Structures Identified/Visualized During 3. Reoperative Parathyroid Surgery 13. RIGHT INFERIOR Parathyroid Location Utilized (select all that apply) RIGHT Lateral Neck Dissection a. Yes, persistent disease (prior operation with failure 14. LEFT SUPERIOR Parathyroid Location a. Monopolar electrocautery (Select from options below) of PTH and/or Ca to normalize postoperatively or 15. LEFT INFERIOR Parathyroid Location b. Bipolar electrocautery 5. Structures Removed and/or Sacrificed remain normal for > 6 months) c. Electrothermal vessel sealing device During RIGHT Lateral Neck Dissection b. Yes, recurrent disease (rise in PTH and/or Ca after Type A: Adherent to the posterior thyroid parenchyma (i.e. (LigasureTM or equivalent) (Select from options below) normalization
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