Endoscopic Pituitary Tumour Excision

Endoscopic surgery is performed through the nose to remove tumors from the pituitary gland and skull base. In this minimally invasive surgery, the surgeon works through the nostrils with a tiny endoscope camera and light to remove tumors with long instruments. Pituitary tumors can cause hormone problems and vision loss. Tumor removal often reverses vision problems and restores normal hormone balance.

Endoscopic pituitary tumor excision, also known as endonasal endoscopic transsphenoidal surgery, is a minimally invasive surgical procedure used to remove tumors that develop in or around the pituitary gland. The pituitary gland is a small pea-sized gland located at the base of the brain, and it plays a crucial role in producing and regulating hormones that control various bodily functions.

During an endoscopic pituitary tumor excision, the patient is typically placed under general anesthesia. The surgery is performed through the nasal cavity and does not require any external incisions. Instead, specialized endoscopic instruments are used to access the pituitary gland through the sphenoid sinus, which is a small air-filled space behind the nasal passages.

Preparation : The patient is positioned on their back, and a breathing tube may be inserted to help with anesthesia and ensure a clear airway during the surgery.

Nasal Cavity Access: The surgeon inserts an endoscope (a thin, flexible tube with a light and camera) through one of the nostrils and advances it towards the sphenoid sinus. Small instruments are used to remove any obstructions, like bone or tissue, that may be blocking the pathway.

Tumor Localization: Once the pituitary gland is visualized, the surgeon uses the endoscope to identify and locate the pituitary tumor.

Tumor Removal: Using specialized instruments, the surgeon carefully removes the tumor tissue. The endoscope provides a magnified view, allowing for precise and controlled removal of the tumor while minimizing damage to surrounding healthy tissue.

Closure: After the tumor has been completely removed, the surgical instruments are withdrawn, and the incisions made in the nasal cavity are allowed to heal naturally. There is no need for sutures in this type of surgery.

Recovery: The patient is taken to the recovery room to wake up from anesthesia. They are usually closely monitored during this time. Depending on the extent of the surgery and the patient's condition, they may stay in the hospital for a short period for observation.

Advantages of endoscopic pituitary tumor excision include shorter hospital stays, reduced post-operative pain, faster recovery, and a lower risk of complications compared to traditional open surgical approaches.

It's important to note that the specifics of the surgery may vary depending on the size and location of the pituitary tumor and the individual patient's medical condition. The procedure is typically performed by a skilled neurosurgeon or an ENT (ear, nose, and throat) surgeon with expertise in endoscopic skull base surgery.

After an Endoscopic Pituitary Tumor Excision, also known as endonasal transsphenoidal surgery, patients can expect several things during the recovery period. Here are some common expectations:

1. Hospital Stay: Most patients will need to stay in the hospital for a few days following the surgery. The length of stay depends on the extent of the surgery and the overall health of the patient.

2. Pain and Discomfort: Pain and discomfort are common after the surgery, especially around the nose and in the surgical area. Pain medications will be provided to manage the discomfort.

3. Nasal Drainage: There will be some nasal drainage, which may be mixed with blood. This is normal and should improve over time.

4. Swelling: Swelling around the face, eyes, and nose is common and can take a few weeks to fully resolve.

5. Fatigue: It's normal to feel tired and fatigued after surgery. Adequate rest is essential for a smooth recovery.

6. Restrictions: There may be activity restrictions, including avoiding strenuous activities, bending, or lifting heavy objects, for a period specified by the surgeon.

7. Follow-up Appointments: Regular follow-up appointments with the surgeon are essential to monitor the healing process and address any concerns.

9. Hormonal Changes: In some cases, there might be hormonal changes, especially if the tumor was affecting the pituitary gland's normal function. Hormone replacement therapy may be necessary.

10. Visual Improvement: If the tumor was causing visual disturbances, there is a possibility of improvement in vision after the surgery.

11. Pathology Results: The tumor tissue removed during surgery will be sent for analysis to determine its nature (benign or malignant).

12. Resumption of Normal Activities: The time it takes to return to normal activities, including work, will vary from person to person. It depends on the nature of their job and the extent of the surgery.

It's important to note that every patient's experience may differ, and the specific details of the recovery will be discussed with the surgeon before and after the procedure. Adhering to the post-operative care instructions and attending follow-up appointments are crucial for a successful recovery. If you or someone you know is undergoing this procedure, it's essential to communicate any concerns or unusual symptoms to the healthcare team promptly.