For the treatment of hyperthyroidism, it is usually considered that the first choice is conservative medical treatment, but in actual clinical work, surgery still has its irreplaceable position. The indications for surgical treatment include: 1. Relapse after anti-thyroid medication and enlarged thyroid gland of degree II or above. 2. Enlarged thyroid gland compressing adjacent organs and showing symptoms of compression. 3.Medium or severe hyperthyroidism with ineffective long-term drug treatment or poor results. 4.Suspected to co-exist with thyroid cancer. 5.Adolescent patients who cannot adhere to medication and have unsatisfactory symptom control, affecting study, work and rest. 6.Patients with poor control of hyperthyroidism medication during pregnancy and those with allergic reaction to antithyroid medication can be treated surgically in the middle of pregnancy (13th to 24th week). Pre-operative preparation: 1. Pre-operative preparation Hyperthyroidism surgery is an elective surgery, which must be well prepared before surgery to ensure smooth operation, reduce intraoperative bleeding and avoid postoperative crisis. It has been proved that it is safer to use the preparation method of overlapping anti-thyroid drugs and iodine. The mechanism of thyroid crisis is not clear yet, but recent studies mostly believe that it is caused by insufficient secretion of adrenocortical hormone. The use of hormones on the day of surgery and after surgery can prevent the occurrence of crisis, prevent laryngeal edema and reduce postoperative reactions. The incision is made 1.5 cm above the sternotomy, and a transverse arc-shaped collar incision is made at the transverse neckline. The key to the protection of the superior laryngeal nerve is the exposure of the superior pole. The superior pole is fully exposed, and the anterior and posterior branches of the artery are ligated visually away from the thyroid cartilage and close to the thyroid envelope, avoiding ligating the artery together with the surrounding tissues to prevent damage to the superior laryngeal nerve. Protection of the recurrent laryngeal nerve. In subtotal thyroidectomy, the parts of the laryngeal nerve prone to injury are on the posterior side of the gland and the inferior pole. We use the intraperitoneal branch ligation method when dealing with the inferior thyroid artery to avoid dissecting the tracheoesophageal groove and to preserve the integrity of the posterior peritoneum of the gland to ensure the injury of the nerve. 3. Protection of the parathyroid glands The parathyroid glands are located on the back of the gland. We use the method of not ligating the main trunk of the inferior thyroid artery, preserving the integrity of the peritoneum on the back of the gland, preserving all the loose tissues of the inferior pole of the thyroid gland, and strictly wedge excision, which not only preserves the blood supply of the parathyroid glands, but also prevents accidental excision of the parathyroid glands. The amount of glandular excision depends on the type of hyperthyroidism, the original basal metabolic level, T 3 and T 4, the manifestation of hyperthyroidism, the degree of glandular enlargement and the age of the patient. Generally, about 80% to 90% of the gland is excised and about 6 to 8g of the gland is preserved. 5. Postoperative drainage Postoperative drainage can ensure observation and evaluation of the disease, and the silicone tube can be used to connect to the negative pressure drainage method.