Pituitary Tumor Surgery: Protect Yourself From Malpractice

As a trial lawyer, I have handled numerous medical malpractice cases over the years, and it has required that I learn a great deal of medicine. While some of it is fascinating, some is downright frightening. In fact, I now subscribe to the belief that the only type of “minor surgery” is when they are operating on someone else….other than me or my family! Pituitary tumor surgery is certainly no exception.

The pituitary is an endocrine gland located in a small cavity at the base of the brain. Pituitary tumors are abnormal growths that develop in the gland and are usually benign (non-cancerous). Nevertheless, as they grow in size the tumors can cause problems such as vision loss, double vision, drooping of the eyelids, severe headaches, and hormone imbalance which can cause lightheadedness, excessive thirst, fatigue and cold intolerance. One of the most common forms of treatment for pituitary tumors is surgical removal. Most can be removed transsphenoidally (through the sphenoid sinus cavities located behind the nose).

Others can be removed transcranially (through the upper part of the skull). While it may be hard to believe from looking at this diagram, generally these surgeries are relatively safe when performed by experienced surgeons. For this reason, you should always make sure your team of surgeons (surgeries are typically performed by an ear, nose and throat surgeon together with a neurosurgeon (brain surgeon)) have received specialized training and perform numerous pituitary tumor surgeries each year.

Like all surgeries, pituitary tumor surgery is accompanied by the risk of complication. Because the pituitary gland is located next to the skull base, it is extremely important for surgeons to maintain the proper angle of approach and an awareness of surrounding anatomy. Serious complications can occur if the wrong angle of approach is utilized. For example, if the surgeon dissects above or beyond the tumor mass, he can penetrate the skull base and cause damage to the brain and surrounding arteries.

While some injuries cannot be avoided, others occur simply because the surgeon(s) was negligent (failed to exercise that degree of skill and care generally required of surgeons under similar circumstances). Injuries which can occur include:

• Damage to the carotid arteries leading to stroke or death

• Permanent loss of vision

• Spinal fluid leak or spinal cord damage

• Infection and/or meningitis

• Brain injury or brain damage

So what should you do to protect yourself against a bad outcome? First, make sure your surgeons have lots of experience. In this day and age there are tons of resources available on the web to help you find the best team of surgeons. Read on-line articles about the surgery and then note who authored them. Contact the author’s office and get a recommendation. You will be surprised how helpful their staff can be. The author himself may even be willing to see you or make a referral. Most experienced surgeons—experts—will be in large metropolitan areas and/or teaching hospitals. This is especially true of accomplished neurosurgeons. To find the best you will probably have to travel, but it is worth the extra money. As I said, they are operating in the middle of your head, this is not “minor surgery” and you want the best.

Once your surgeon is selected, educate yourself about the procedure so you can ask intelligent questions and understand what the doctor tells you. Finally, ask your surgeon directly about his or her level of expertise. How many pituitary tumor surgeries has he or she performed in the last couple of years. If it is a teaching hospital where they train residents, make sure the surgeon you consult is the one who will actually perform the procedure. Tell them directly that you do not want anyone else operating on you. While it is hard to believe, sometimes people travel halfway across the country to see a particular specialist only to have a resident operate on them instead once they are asleep. It really happens. Experience matters in pituitary tumor surgery so insist on the best. Hopefully, if you follow this advice you will enjoy a speedy recovery and will not need suggestions on how to find an experienced malpractice lawyer!
by: Thomas R. Burnside