Pituitary Surgery: Before Your Surgery

What is pituitary surgery?

Pituitary surgery removes an abnormal growth on your pituitary gland. This gland is located at the base of your brain. It makes important chemicals called hormones. Your body uses these hormones for many functions, including growth, sexual development, reproduction, and metabolism. (Metabolism is the way your body uses food for energy.)

You will be asleep during the surgery. You will not feel pain. The doctor can get to your pituitary gland in one of three ways.

  • The doctor makes a cut under your upper lip. This is called an incision. Then the doctor puts a thin, flexible tube called a scope through the incision. The tube has a small camera on the end. The camera helps the doctor find the gland. Next, the doctor uses special tools to cut out the growth and remove it through the incision. Then the incision is stitched up.
  • The doctor makes an incision in the back of your nose. You may get another one under your upper lip. Then the doctor puts a thin, flexible tube called a scope through one of these incisions. After the tube reaches the pituitary gland, the doctor uses special tools to remove the growth through your nose. After this surgery, you may not need stitches. The doctor may use a small piece of fat from your belly or thigh to plug up the hole in your nose. This helps prevent spinal fluid from leaking out of your nose. If this is done, you will have a small scar on your belly. It will fade with time. You will not have a scar on your face.
  • In rare cases, the doctor makes an incision near the top of your head. The doctor uses special tools to remove bone that is part of your skull. Then the doctor gently makes their way to your pituitary gland. Next, the growth is cut out. Then the doctor replaces the piece of bone and attaches it with metal plates and clamps.

This surgery usually takes about 2 to 3 hours. If the doctor goes under your lip or through your nose, you will probably leave the hospital in 1 to 3 days. You will probably be able to return to work or your normal routine in 1 to 2 weeks. If your doctor goes through your skull, you will probably leave the hospital in 3 to 9 days. But it may take 4 to 6 weeks to fully recover.

After surgery, your symptoms may go away. For example, your vision may improve. Or your headaches may go away. If the growth comes back, or if the doctor could not remove the whole growth, you may need other treatment. This may include radiation therapy.

After the surgery, you may need to take medicines to replace the hormones made by the pituitary gland.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

 
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

 
  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 2 to 3 hours.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.