Awareness of the anomalies of the recurrent laryngeal nerve as here the presence of non-recurrent recurrent laryngeal nerve, preservation of intact blood supply to both parathyroid glands, the careful release of the ligament of Berry where the recurrent laryngeal nerve is so near and more liable for injury, dividing the superior thyroid vessels so near to the upper pole of thyroid lobe to avoid injury of the external laryngeal nerve, and last and not least is to work in a bloodless field (not like my field here), all are essentials for complete perfect total thyroidectomy.
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