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This website is intended for an international audience, excluding the United States, Canada and France

What are the aims of surgery?

Richard gives advice on what to expect from pituitary surgery

01:29

The aim of surgery is to remove the tumour completely.

If this is not possible because parts of the tumour have grown

 

into surrounding structures where they cannot be removed, the goal is to reduce the size of the tumour as much as possible.

 

This patient testimonial reflects only this person’s opinions about their own care. Each person’s case is unique and you should always consult a doctor for information and advice about the diagnosis and treatment of acromegaly.

 Please note that all treatments may have side effects. They vary depending on the treatment and how your body reacts to it. Ask your doctor about side effects when considering a given treatment.

How is surgery performed?

Surgical procedures used today are very sophisticated and a neurosurgeon who specialises in removing pituitary tumours will carry out your operation. This type of surgery is always performed under general anaesthesia, which means that you will be put to sleep by an anaesthetist before the procedure.

The vast majority of procedures will be carried out through the nose of the patient as this is the most direct way to access the pituitary gland. Doing the operation this way means that there is no visible scarring and your stay in hospital should be short. The operation will normally take about 1 to 2 hours and you will be in hospital for about 5–7 days in total.

Surgery can be performed either as a micro-neurosurgical or an endoscopic procedure. The method used depends on the preference of the surgeon who carries out the operation. In experienced hands, both will yield equally good results.

During the surgery the neurosurgeon will then make a small cut in the back of the wall of your nose or mouth (this is transsphenoidal surgery) so that he or she can see to remove the tumour in the pituitary gland.

Very occasionally an operation through the skull (transcranial surgery) may need to be done instead.

Whether it is possible to completely remove the tumour and restore growth hormone levels to normal depends on the size and position of the tumour.

If the tumour is small and completely accessible, surgery alone may be successful and no further treatment will be required.

Are there side effects from the surgery?

Your surgeon will advise you about the possible complications that sometimes occur from the surgery.

No surgery is without risks and sometimes the operation may damage some other parts of the pituitary gland and this may cause a reduced production of some other hormones. If this occurs, you can take replacement hormone therapy. This replacement hormone therapy may only be for a short while after your operation or it may be for the rest of your life.

Oral hydrocortisone may be given after surgery as a precaution until blood tests confirm that surgery has not damaged pituitary control of adrenal gland function. You should carry a card noting that you are on this medication in case of an emergency so that a hydrocortisone injection can be given if needed.

You may also experience side effects from the general anaesthetic such as feeling sick after surgery, a sore throat or stuffy nose and headache; but most people are not affected.

Pain relieving and other medications will be given to you to ease these temporary symptoms. You may also feel very tired after the surgery.

It is important to let your healthcare team know immediately if you feel unwell for any reason in the first few weeks after your operation. Specially, let them know if you have severe headaches or notice clear fluid coming down one or both nostrils.

Clear fluid escaping down the nostrils is potentially due to leak of the cerebral spinal fluid (CSF) that surrounds the brain and you might need an operation to seal the leaking area. There is a small risk of meningitis while the leak remains so it is important to see your endocrinologist or neurosurgeon as soon as possible. This side effect can also occur some years after surgery, as in Maria’s case highlighted below.

“Three years after my operation I noticed I had a few drops of liquid running down my nose in the morning each time I got out of bed. I informed my endocrine nurse and I was later referred for another operation to repair a CSF leak.

Maria, Living with acromegaly

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Ipsen
Please always consult a healthcare professional if you require healthcare advice or if you have any specific concerns regarding your acromegaly, its treatment or side effects. The information provided here is not intended to replace professional advice. This website has been developed by Ipsen in collaboration with those living with acromegaly and the healthcare professionals who care for them. Ipsen would like to thank everyone for their valuable insights and stories. All names used on this website are not necessarily real names. Visit our website for more information about us, or to contact us directly. Website design and development by Kanga Health Ltd. Website reference SOM-ALL-000556