1. Introduction to Pituitary Surgery: The Patient Experience Andrew S. Little, MD Co-Director of the Barrow Interdisciplinary Skull Base Team Acute Care Director at the Barrow Neurological Institute Assistant Director of the Barrow Pituitary Center

2. Patient Persepctive Anxiety Fear of Unknown Pain Complications Will I be the same person? “Brain Surgery”

3. Neurosurgeons: Back Then

5. Neurosurgeons: Now

6. Diagnosis Pre-op Testing Evaluation Surgery Recovery Medical Team Life

7. Preoperative Testing Determine the medical risks of surgery –Heart –Lungs –Blood clotting –Kidneys –Blood levels

9. Preoperative Testing

10. Diagnosis Pre-op Testing Evaluation Surgery Medical Team

11. Day of Surgery Preoperative holding –Nurse starts iv Meet the surgical team –Nurses –Scrub –Anesthesiologist “The Gas Passer” –Surgeons

12. Day of Surgery Hugs & Kisses Light sedation –“Intravenous margarita” –Most patients don’t remember anything after this

13. Surgical Suite

16. Endoscopic Instrumentation Kassam/Snyderman set

17. Technical Advancements: Dual Function Instruments Irrigating DrillTissue Debrider

18. Technical Advancements: Dual Function Instruments Adjustable Endoscope

19. Technical Advancements: Dual Function Instruments Ultrasonic Aspirator

20. High-Definition Video Equipment

21. High DefinitionLow Definition

22. Diagnosis Pre-op Testing Evaluation Surgery Recovery Medical Team

23. Recovery

25. Diagnosis Pre-op Testing Evaluation Surgery Recovery Medical Team Life

26. Quality of Life Social + physical + emotional well being

27. Anterior Skull Base Nasal Inventory

28. Nose Symptoms

29. Nasal Quality of Life: Preliminary Data (n = 60) Nasal General

30. FAQs How long will it take me to recover? –Every patient is different –Recovery is a process, not an endpoint –1-2 months before you feel back to normal When can I go back to work? –2-4 weeks, depending on demands of job –Tell your employer you need one month off

31. FAQs When can I blow my nose? –4-6 weeks When can I drive? –Off narcotics –Vision improved When can I swim? –4-6 weeks When can I fly? –Anytime

33. A Special Thanks to our Sponsors Barrow Neurological Institute Corcept Ipsen KARL STORZ Endoskope