Safe Thyroidectomy without Nerve Detector Stimulation. A Maneuver Adds More Safety during Total Thyroidectomy, Comparative Study

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.