Also called transsphenoidal endoscopic surgery, this is the most common surgery used for pituitary tumors. The pituitary gland is a small gland that sits at the base of your brain behind your sinuses and above the roof of your mouth. It controls most of the hormones in your body.

For the procedure, your surgeon will insert a small, thin tube with a camera on the end (called an endoscope) through your nose or upper lip. The camera projects an image onto a television screen. Your surgeon will watch the screen as they insert other instruments through the endoscope to remove the tumor.

Tumors Treated With Surgery

• Hormone-secreting tumors. These tumors are removed because they affect hormone levels.
• Nonhormone-secreting tumors (endocrine inactive pituitary adenomas). These tumors may be removed. As they grow, they can cause headaches and vision problems.
• Cancerous tumors. Surgery may be done with other treatments.

Risks of Surgery

Surgery is generally considered safe. However, all surgeries come with risks. Side effects can include reactions to anesthesia, bleeding and infections.

What to Expect Before Surgery

You may need to see an endocrinologist (gland and hormone specialist) before your procedure. You may also have your vision checked.

Your surgeon will tell you how to prepare for surgery. You may need to:

• Stop eating and drinking at a certain time. The surgery is often done under general anesthesia.
• Temporarily stop taking certain medications that increase the risk of bleeding during surgery. Do not use any over-the-counter medications without talking to your surgeon.
• Have certain tests. These may include blood tests, a heart rhythm test and a chest X-ray. Your surgeon will look at the results of these tests before your surgery.

What Happens During Surgery

Expect the surgery to take a few hours. Your surgeon may work alongside an ear, nose, and throat (ENT) specialist.

Your surgeon will insert the endoscope through your nose or an incision in your upper lip. They will insert it until it makes contact with the bony wall of your sphenoid sinus. This is located at the back of your nose. Then, they will open the sphenoid sinus, and insert the scope through to the back wall of the sinus. Next, they will make a small opening in the back wall of the sinus. Then they will remove the tumor in small pieces. Once those pieces are gone, they will take out the endoscope. Your surgeon may also use MRI to get images of the pituitary area and to help guide the procedure.

What to Expect After Surgery

You may need to stay in the hospital for one or two days. Your care team will help you with your dressings and bathroom needs. If you are taking fluids well, you may be able to eat a normal diet. You will likely need to help keep track of your fluid intake and urine output. Your care team will also encourage you to get out of bed and walk around as soon as you are able to.

Once you are home, you may need pain medication to help with headaches. Ask your surgeon what to expect during recovery. Be sure to ask if there are any activities you should avoid.