ENDOSCOPIC PITUITARY SURGERY
The pituitary gland is a small gland located at the base of the brain just behind the bridge of the nose. It controls most of the body's hormones, the chemical messengers that circulate in the blood. Growth of this gland in the form of a tumour generally presents with visual disturbance or hormone imbalance syndromes such as Cushing's disease or acromegaly. As this area is deep within the brain but very close to the nasal passages, the use of an endoscope will allow access to this area for the removal of a tumour through the nose. This type of keyhole surgery is known as transsphenoidal endoscopic endonasal surgery. Endoscopic pituitary surgery, is an elegant procedure for removing pituitary tumours.
WHEN IS THIS TYPE OF NEUROSURGERY NECESSARY?
The growth of a tumour from the pituitary gland can cause blindness or significant hormonal imbalance. These factors and the tumour size will be used to deduce if surgery for your pituitary tumour is necessary.
HOW IS ENDOSCOPIC PITUITARY SURGERY DONE?
In Gauteng, South Africa, Professor Christos Profyris performs pituitary tumour surgery through an endoscopic transsphenoidal approach. Imaging and mapping technologies are used to guide the surgery. An endoscope, a thin tube-like tool fitted with a light source and camera, is inserted into the nostril to the sphenoid sinus at the back of the nasal cavity. Here, an incision is made to open the sphenoid sinus and access the bone surrounding the pituitary gland. The bone around the pituitary is then removed, and the tumour is resected. The surgery aims to completely resect your pituitary tumour with the aim of achieving cure. Professor Profyris has significant experience with resecting pituitary tumours through an endoscopic endonasal approach. Professor Profyris also has significant experience with giant and complex pituitary tumours.
BENEFITS OF THE ENDOSCOPIC TRANSNASAL APPROACH TO SURGERY INCLUDE:
- Potential Improvement of vision
- Improved visualisation of the pituitary gland and tumour
- Minimal trauma/exposure of the healthy tissues
- More rapid post-surgical recovery
- Shorter hospital stays
- No visible scars
PITUITARY SURGERY
This is a case of a giant pituitary tumour (andenoma) operated on by Professor Profyris through an endoscopic endonasal approach. The green arrows on the left hand images demonstrate the pituitary tumour which has been removed, as can be seen by the images on the right. The patient regained their visual loss.
Another case of a giant pituitary tumour (andenoma) operated on by Professor Profyris through an endoscopic endonasal approach. The green arrows on the left hand images demonstrate the pituitary tumour which has been removed, as can be seen by the images on the right. he video below shows the endoscopic intra-operative footage from removal of this tumour. T he video below shows the endoscopic intra-operative footage from removal of this tumour.
Another case of a giant pituitary tumour (andenoma) operated on by Professor Profyris through an endoscopic endonasal approach. The green arrows on the left hand images demonstrate the pituitary tumour which has been removed, as can be seen by the images on the right.
FAQ
The answer to this is highly variable. The most important aspect of endoscopic pituitary surgery is safety. Depending on the exact location, type and size of tumour there can be a huge variation in time. With time ranges of less than an hour to many, many hours. The use of minimally invasive approaches and careful study of your pathology through pre-operative imaging can save significant time in theatre.
As a high-volume tumour practice, we have significant experience with endoscopic pituitary surgery and with resecting giant pituitary tumours. We generally resect giant pituitary tumours through an endoscopic endonasal response and have a high percentage of gross total resection.
Recovery is highly variable. However, the keyhole techniques that Professor Profyris utilises allow for faster recovery. Most patients undergoing endoscopic pituitary surgery are discharged from hospital after very few days and generally recover fairly quickly. Actual recovery will depend on factors such as tumour size and location. Importantly most patients recovery their vision very quickly. Professor Profyris will have a detailed conversation with you about this.
