Introduction: Last Decades, Date by date medical developments providing friendly, high-efficiency treatment equipment and services in developed countries are working toward an advanced, as our country medical services are trying to that country’s technology has been introduced. In our country every day there is only surgical care necessary to endocrine gland disorders, including most common thyroid surgery. It is open and robotic assistant endoscopic surgery in the world. But robotic assistant endoscopic surgery is too expensive and impossible in our country. Thus we chose Thunderbeat for open thyroid surgery in especially huge enlarged goiter and vascularized goiter to try prevent bleeding, recurrent laryngeal nerve palsy and post operation hematoma and other complications Thunderbeat is new generation instrument combines an advanced bipolar clamp to the existing ultrasonic cutter. Materials and Methods: M 51-years-oldwoman was admitted to Mongol Hyundae hospital because of front of neck pain, multi nodular goiter, tachycardia, sweaty and not controlling emotion. Anamnesis: She diagnosed to Thyrotoxicosis in 2005 and she took medicine last ten years but not controlling that poisoning. Status locals: Huge enlarged goiter in front of her neck Treatment plan: 1. Preoperative Preparation 2. Operation: Open total thyroidectomy 3. Medicine 4. Wound dressing 5. Observation We did operation after day of admission day, Patient is placed in a Semi erect position with a folded sheet underneath the shoulders so that the head is sharply angulated backward on the multifunctional surgical table under general anesthesia. We used thunderbeat from muscular to all procedures, dissection both thyroid gland and isthmus after Kocher skin incision and sub skin tissue dissected. There is no complication while procedure and post operation days Result: Nodular hyperplasia of thyroid gland with focci of micro adenomatous change Conclusion: Thunderbeat in use open thyroid surgery first outcomes blood loss than 30ml, no injury of recurrent laryngeal nerve and no penetration ligament of Berry while procedure, second outcomes no hematoma, painless, wound healing process faster and short time hospitalization.