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Surgeons Introduce A New Minimally Invasive Surgery for the Removal of Pituitary Tumors

 

In Brief:

  • A new surgical procedure removes pituitary tumors and provides patients with a faster recovery time and less discomfort. The procedure is called minimally invasive Endoscopic Endonasal Transsphenoida.
  • Advantages to this procedure include: faster operation time; less trauma to normal tissuel better precision and control for the surgeon; less pain and discomfort after surgery; and a shorter hospital stay and recovery.

A pituitary tumor is an abnormal growth in the pituitary gland, the part of the brain that regulates the body’s balance of hormones. Most pituitary tumors are non-cancerous, but they can cause a variety of hormone problems. As the tumor enlarges, it may compress the optic nerves and cause blindness. Surgery to remove the tumor is often necessary.

If someone is diagnosed with a pituitary tumor, the first steps are usually a thorough endocrine testing by a primary care physician or an endocrinologist and an ophthalmology evaluation for central and peripheral vision. Next, patients typically follow up with a neurosurgeon to discuss the best form of treatment along with a team that includes the endocrinologist, ophthalmologist and otolaryngologist. “Not every patient requires surgery and some types of tumors respond well to medication or can be observed with periodic MRIs to watch for growth,” says Michael Stanley, M.D., F.A.A.N.S., chief of the Division of Neurosurgery at Crozer-Chester Medical Center.

Many times, pituitary tumors can be approached from underneath through the nose and sphenoid sinus, called the transphenoidal approach. The traditional surgical procedure uses a skin incision under the lip and removal of a large portion of nasal septum so that the surgeon can directly see the area using a microscope. Because it required the physician to break the nose and relocate the nasal septal bone and cartilage, patients needed nasal packing and could expect an uncomfortable four- or five-day hospital stay.

Now, a new less invasive surgical procedure removes pituitary tumors and provides patients with a faster recovery time and less discomfort. Offered to patients at Crozer,  Endoscopic Endonasal Transsphenoidal surgery uses computer guidance and endoscopic vision to remove the pituitary tumor. Patients may go home as early as the next day.

During the endoscopic procedure, the surgeon places an endoscope through the nostril and into the sphenoid sinus. Using computer guidance, tiny surgical instruments are used to remove the tumor without disruption of normal sinus and septal structures. Because the endoscope projects a lighted, magnified view of the sinus and pituitary area onto a video monitor, the surgeon has a much better view of the tumor and surrounding tissue. A neurosurgeon performs transsphenoidal surgery with an otolaryngology (ear, nose, and throat) surgeon. A team approach allows comprehensive care of both brain-sinus-related issues before, during, and after surgery.

“After the surgery, you need to follow up with your otolaryngologist and neurosurgeon to check the surgical site. Typically, it will take a few weeks for your nasal cavity to heal versus the traditional surgery where it may take many months to health completely,” says Kenneth B. Briskin, M.D., FACS, chief of Otolaryngology at Crozer-Chester Medical Center.

“Utilization of computer guidance has dramatically helped to improve the safety of skull base brain surgery. At Crozer, the Neurosurgery and Otolaryngology team approach leads to better communication and pre-operative coordination so that surgery time is reduced and the recovery period is much quicker and significantly less painful,” says John M. Feehery, M.D., chief of the Section of Otolaryngology at Taylor Hospital.

To find an endocrinologist, neurosurgeon or otolaryngologist who is right for you, call 1-800-CK-HEALTH (1-800-254-3258).
 

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