Pituitary Surgery: Before Your Surgery

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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, sex, 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 he or she 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 he or she stitches up the incision.
  • 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. He or she uses special tools to remove part of your skull. Your skull is the bone that surrounds your brain. Then the doctor gently moves your brain out of the way to get to your pituitary gland. Next, he or she cuts out the growth. Then the doctor puts your skull back in place 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.

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

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

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

Preparing for surgery

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers 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 cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • 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.

Going home

  • Be sure you have someone to drive you home.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

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.

Where can you learn more?

Go to http://www.healthwise.net/ed

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