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Pituitary Surgery

The pituitary gland, often referred to as the “master gland”, sits at the base of the brain and regulates many of the body’s hormones.

Disorders of the pituitary can cause a wide range of symptoms, from vision changes to fatigue, weight gain, infertility, and metabolic disturbance.

Pituitary tumours are relatively common, accounting for around 10–15% of all brain tumours diagnosed in Australia. Most are benign, but because of their location, they can compress surrounding structures such as the optic nerves or disrupt hormonal balance.

A/Prof Peter Mews has advanced training in endoscopic pituitary surgery (neuroendoscopy), a minimally invasive approach performed through the nasal passages, which avoids external scars and allows precise removal of tumours with faster recovery. He regularly manages patients with pituitary disorders across Canberra, Wagga Wagga and the South Coast.

What is Pituitary Surgery?

Pituitary surgery is performed to remove tumours or cysts affecting the gland when they cause symptoms or threaten vision and hormonal function.

The modern standard approach is endoscopic endonasal surgery, where a small camera and specialised instruments are passed through the nostrils to access the tumour directly.

Benefits of endoscopic pituitary surgery include:

  • No external incisions or visible scars
  • Reduced pain and faster recovery compared to open approaches
  • High-definition visualisation of the tumour and surrounding anatomy
  • Precise removal while preserving normal pituitary and brain tissue
  • Shorter hospital stays and quicker return to daily activities

Conditions Treated with Pituitary Surgery

Pituitary adenomas are benign tumours arising from the cells of the pituitary gland. They may secrete excess hormones or simply cause pressure on nearby structures.

Causes:

  • Usually sporadic, but may rarely be part of genetic syndromes such as MEN-1

 

Symptoms:

  • Visual loss or blurred vision (compression of the optic chiasm)
  • Headaches
  • Hormonal changes (depending on tumour type):
    • Prolactinoma: infertility, menstrual disturbance, galactorrhoea
    • Growth hormone-secreting: acromegaly, enlarged hands/feet, coarse features
    • ACTH-secreting: Cushing’s disease, weight gain, diabetes, hypertension
    • Non-functioning adenoma: often present with visual symptoms rather than hormonal excess

 

Treatment options:

  • Observation (small, non-symptomatic tumours)
  • Medication (especially prolactinomas)
  • Endoscopic pituitary surgery for symptomatic, large, or medication-resistant tumours
  • Radiotherapy in selected cases

Craniopharyngiomas are rare, benign tumours that arise near the pituitary gland and hypothalamus. They often occur in children or young adults.

Causes:

  • Thought to arise from embryonic remnants near the pituitary

 

Symptoms:

  • Visual loss
  • Headache
  • Growth and hormonal disturbances in children
  • Fatigue and weight gain

 

Treatment options:

  • Surgery (endoscopic or combined approaches)
  • Radiotherapy for residual or recurrent tumours

These are benign cysts that form from remnants of embryonic tissue in the pituitary. They may remain silent or cause symptoms if they enlarge.

Symptoms:

  • Headaches
  • Visual disturbance
  • Hormonal dysfunction

 

Treatment options:

  • Observation if asymptomatic
  • Endoscopic drainage or excision if symptomatic

Several other lesions may involve the pituitary region and require surgery for diagnosis or treatment. These include:

  • Meningioma of the tuberculum sellae
  • Hypophysitis (inflammatory conditions mimicking tumours)
  • Metastases to the pituitary
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Why Choose A/Prof Peter Mews?

Pituitary surgery requires exceptional skill and precision. The endoscopic endonasal approach, while minimally invasive, is technically demanding due to the proximity of the optic nerves, carotid arteries and normal pituitary tissue.

A/Prof Mews is fellowship-trained in endoscopic brain surgery, with a particular focus on pituitary and skull base tumours. His expertise ensures that patients benefit from state-of-the-art surgical techniques, delivered with a strong emphasis on safety and long-term outcomes.

By consulting across Canberra, Wagga Wagga and Moruya, he makes advanced pituitary surgery accessible to patients across the region, without the need for travel to major metropolitan centres. For many, this means timely diagnosis, effective treatment, and a faster return to normal life.

Learn More About Dr Mews