Endoscopic Pituitary Surgery: An In-depth Insight
Endoscopic pituitary surgery, or trans-sphenoidal endoscopic surgery, is the most common surgery required to remove pituitary tumours. The pituitary gland is located deep in our brain and above the inside of our nose. The pituitary gland is known for regulating most of our hormones, the chemical messengers that move through our blood. Neurosurgeons perform endoscopic pituitary surgery with an endoscope. We knew that an endoscope was a thin, rigid tube with a microscope, light, and camera built into it. Experts use it, and they usually insert it through the nose. The procedural neurosurgeon watches it on a television screen while inserting other special instruments into the scope.
Endoscopic Transsphenoidal Surgery
What are the reasons for endoscopic pituitary surgery?
Experts perform endoscopic pituitary surgery to remove certain types of tumours that start to grow in your pituitary gland.
Hormone-secreting tumours.
These developments secrete chemical messengers that move through the blood.
Non-hormone-secreting tumours.
These developments are also called endocrine-inactive pituitary adenomas. Experts removed it with the help of surgery. As the size increases, the patient will have headaches and visual disturbances.
Cancerous tumours.
Experts treat these thickenings with surgery, cancer drugs, and X-ray treatment.
What are the risks involved in endoscopic pituitary surgery?
Experts treat endoscopic pituitary surgery as a safe treatment; however, almost all surgical operations entail the risk of an anaesthetic response, bleeding, and infection.
Threats and complications that may occur with this type of surgical procedure include the following:
CSF rhinorrhea.
We can identify the part of cerebrospinal fluid that surrounds the brain. CSF fluid may leak from the nose after surgery. In some cases, surgeons may perform another surgery to repair this leak.
Meningitis.
Meningitis is an infection that falls in the lining membrane of the brain and the spinal cord and happens after endoscopic pituitary surgery.
Meningitis is more frequent if the CSF leaks.
Experts expect some harm to common parts of the pituitary gland. After surgery, injury to the pituitary gland that releases hormones may necessitate HRT (hormone replacement therapy).
Diabetes insipidus.
A part of the pituitary gland that helps control urination may be impaired, leading to frequent urination and thirst.
Severe bleeding.
Blood vessels in the brain or nostrils are often damaged during surgery, causing heavy bleeding.
Visual problems.
The nerves that provide eyesight are close to the area of the pituitary gland and can be affected by it.
Other complications may exist, depending on your medical condition. Before the surgical procedure, share any concerns you have with your surgeon.
What precautions should a patient take before endoscopic pituitary surgery?
You may need to see an endocrinologist specialist for a diagnosis before surgery. The faculty of endocrinologists are medical specialists who handle glands and hormones. You may also have your eyesight checked before surgery. Neurosurgeons perform endoscopic pituitary surgery under general anaesthesia, and they advise you to stop eating and drinking after midnight the night before the operation. Your doctor prescribes that you stop taking certain medications that may increase bleeding during surgery (NSAIDs).
You should not consume any OTC medications before surgery without consulting your doctor. You will receive several blood tests, a heart rhythm test, and a chest X-ray. Your doctor will check it before surgery, and you will need to be examined by the doctor who performs anaesthesia.
What happens during endoscopic pituitary surgery?
Surgeons typically perform endoscopic pituitary surgery under general anaesthesia. The surgeon inserts the endoscope through one nostril and carefully navigates through the nasal cavity and sphenoid sinus to reach the sella turcica, the bony cavity housing the pituitary gland. Once the surgeon envisions the pituitary gland and any abnormalities, they use highly professional instruments inserted through the endoscope to remove the tumour or perform other necessary procedures.
Medical professionals pack the nasal cavity with material to control bleeding and promote healing after the procedure.
A Minimally Invasive Approach
Endoscopic pituitary surgery may take a few hours. In many cases, an ENT expert will work with a neurosurgeon.
The following steps in the surgery:
A professional ENT expert usually places the endoscope through the nose. Rarely, your surgeon may make an incision under the upper lip. Surgeons stretch the endoscope to the back of the nose, where they can locate the bony wall of the sphenoid sinus. Surgeons open the sphenoid sinus region, and then the endoscope passes through to the back wall of the sinus. Your surgeon opens a small opening on the backside of the sinus wall. Your doctor will order MRIs to make images of the pituitary area using computer and magnet techniques during surgery to help guide the surgeons. When your neurosurgeon enters the pituitary area, they remove the pituitary tumour in tiny pieces. When surgeons remove the affected portion of the tumour region, they remove the endoscope. Surgeons can wrap the nose to complete the procedure.
What precautions should the patient take after endoscopic surgery?
You may need to stay in the hospital for a day or two. During this time, staff will help you with dressing and bathroom needs. If you are taking fluids, you can return to your regular diet. Your doctor encourages you to get out of bed and walk. Your nurses and staff members will monitor your fluid intake and urine output. This process may evaluate your pituitary status.
What precautions should a patient follow at home?
Pain medication to control headaches is the primary complaint after surgery. You may continue your restricted activities without lifting or straining until cleared by your surgeon.
Follow-up visits with your endocrinologist and surgeons
- Repeat MRI
- Visual testing
It is crucial to let your surgeon know about
- Persistent headache
- Nausea and vomiting
- High fever
- Excessive bleeding from the nose
- Excessive water discharges from the nose
- Frequent and increased urination
We can minimize adverse interactions between nutrition and treatment and improve symptoms.
Foods For Brain Tumor Patients
Diet after pituitary surgery
Patients can eat apricots and beets. Patients can avoid foods like cauliflower and green beans and consume a balanced diet when undergoing fluorouracil treatment for pituitary neuroendocrine tumours.
Foods to avoid
- Cauliflower
- Green Beat
Food to eat
- Apricots
- Beetroot
What is the diet after pituitary surgery?
Dietary instructions: following endoscopic pituitary surgery, focus on promoting healing and avoiding complications.
Here's a breakdown of what to expect:
- Resume routine diet: In many cases, you can resume your regular diet fairly soon after surgery.
- Focus on fluids: Staying hydrated is crucial post-surgery. Ensure you drink plenty of fluids as instructed by your doctor.
- Bland diet for stomach upset: If you experience nausea or vomiting, your healthcare provider might recommend a bland diet consisting of easily digestible foods like toast, crackers, rice, and applesauce for a short time.
- Small frequent meals: Eating smaller, more frequent meals throughout the day can be easier on your digestive system than large, heavy meals.
- Protein for healing: Protein is essential for tissue repair and healing. Your doctor might recommend including moderate amounts of protein in each meal.
- Avoid constipation: Straining during bowel movements can stress the surgical site. Your doctor recommends incorporating fibre-rich foods like fruits, vegetables, and whole grains into your diet. Additionally, they might recommend a stool softener to prevent constipation.
Remember: It's vital to follow the specific dietary instructions provided by your doctor after surgery. They will consider your needs and any potential risk factors when making recommendations.
Advances in Diagnosis and Management
Endoscopic pituitary surgery offers an advancement in treating pituitary tumours and other abnormalities. This minimally invasive approach boasts numerous advantages over traditional open surgery, including reduced scarring, faster recovery times, and lower complication risks.
However, it's crucial to remember that endoscopic pituitary surgery is a specialized procedure. Consulting with an experienced neurosurgeon or ENT team familiar with this approach is vital for achieving optimal outcomes. If you suspect you might have a pituitary tumour or other pituitary gland dysfunction, discuss your concerns with your doctor. Early diagnosis and treatment can significantly improve the success rate of endoscopic pituitary surgery and ensure better long-term health.