Multiple thyroid nodules are common, and even if they are solitary, the possibility of recurrence after surgery is not small. For nodular goiter, total thyroidectomy is often advocated abroad, and now there is an increasing trend in China to do total thyroidectomy. This can be avoided by careful dissection under direct vision along the pseudohypophysis and close to the true thyroid envelope. I advocate routine exposure of the recurrent laryngeal nerve. The method of finding the recurrent laryngeal nerve is as follows: the thyroid lobe is free and pulled medially, and the outer middle of the lobe is pulled together by the inferior thyroid artery in an oblique transverse fold. Routine exposure of the recurrent laryngeal nerve can make the surgery thorough and avoid nerve injury. The shape of the recurrent laryngeal nerve varies, most of them are one without bifurcation, but in this patient the recurrent laryngeal nerve forms many bifurcations. The laryngeal entry site is usually 0.5 cm posterior to the inferior angle of the thyroid cartilage. Next to the parathyroid glands