Success of surgery depends on the size and location of the tumor, and the experience and skills of the neurosurgeon. For example, surgery is more successful with a tumor smaller than 10-millimeters compared with a tumor greater than 10-millimeters in size. In our experience, more than 90% of patients have normal GH and IGF-1 hormone levels following surgery. The expertise of the surgical team is a key factor in achieving best possible results with very low complication rates. Recent surgical innovations introduced by Dr. Fernandez-Miranda, such has removal of the medial wall of the cavernous sinus and removal of cavernous sinus tumors, have significantly improved surgical outcomes in acromegalic patients.
Surgery for acromegaly is a delicate procedure, which should be performed by highly specialized surgeons at multidisciplinary Pituitary centers. In the past, the most common operation was an approach called microscopic transsphenoidal surgery. At Stanford, our neurosurgeons and rhinologists use a more advanced endoscopic endonasal approach to access the pituitary gland through the nostrils. Our operating rooms are equipped with 4K endoscopic visualization technology and very fine instruments.