• Ms Kusnur Karim 45/F, case of Papillary thyroid cancer with Tracheal invasion and hemoptysis

• Bronchoscopy: growth protruding below the vocal cords

• Underwent Total Thyroidectomy + resection of tracheal rings along with the growth and end-to-end anastomoses of trachea

Positioning

Opening of strap muscles exposing the thyroid

thyroid

Left lobe thyroid

Left rec laryngeal nerve

Inferior parathyroid

Stony hard Rt lobe thyroid

Tumor bed over tracheaafter tumor shaved off

CCA

Thyroid cartilage

Sling to encricle the trachea

Dividing the trachea above the tumor bed

ET tube inserted from the distal cut end of trachea

Divided portion of trachea

Oesophageal bed from where trachea was removed

Upper cut end

Lower cut end

CCA

Taking bite from lower cut end of trachea

Upper cut end

Anastamosing both the proximal and distal cut ends of trachea with ET tube in the lower end

Anastamosing both the proximal and distal cut ends of trachea after removing the ET tube from the distal end

After anastomoses

Tension relaxing sutures

Suture bite to keep the neck in flexed position

Surgical Specimen-anterior view

Surgical Specimen-posterior view

Resected trachea-anterior view

Resected trachea-inner view

growth

• Patient discharged and planned for RAI therapy