I haven't had surgery Laura, but I will say in all of the time I have supported my friends here, I have heard and have read in the literature that the least invasive route is better for the patient. Many of the surgeons are learning the endonasal approach now. It used to be just a handful of surgeons, two neurosurgeons in Pittsburgh (Dr. Jho and Dr. Kassam), and a skull base surgeon, Dr. Shahinian, in Los Angeles. Those days are changing. More surgeons are learning the approach and more and newer technologies are being used to enhance surgical successes. I recently read a really nice paper from Dr. Ciric in Illinios, and he urged his colleagues to become skilled in both techniques. The most important thing is to see a surgeon who specializes in pituitary surgery. I think also it is important to understand your tumor and understand your expected outcome. In my experience, I have heard that even the top surgeons differ on their advice to patients; sometimes patients have to do alot of their own homework, research, gather opinions based on their tumor presentation and make the best decision for them. Sometimes it involves travel. Do remember though that your endocrinologist is an important part of your team, as this person will be part of your care probably for the rest of your life. It is important to have a good endocrinologist who understands pituitary disease and who will work with you. The link to Greg's story is here . I am so glad he posted. He has had quite a journey himself and I think his experiences with the three surgeries are very valuable. Thanks too Daryl for your kind response to Laura ![]() . Oh... Laura, btw... Welcome to the group ![]() Minnie | 