A 71-year-old woman presents with acromegaly and multiple medical problems associated with the disease. An MRI shows a large pituitary macroadenoma, and surgery is elected. The patient undergoes a microscopic transsphenoidal pituitary adenectomy with insertion of a lumbar subarachnoid drain. The right thigh is opened, and a muscle and fascia plug is taken from the fascia lata. The graft is placed in the sella. The floor of the sella is reconstructed with a piece of bone and is covered with Gelfoam and fat. The wound is closed and dressed, and the lumbar drain is removed.
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