Comparison of Techniques for Transsphenoidal Pituitary Surgery

Abstract

Transsphenoidal pituitary surgery has evolved over the past several decades, because advances in technology have been the catalyst for minimally invasive surgeries. Less invasive approaches, such as the transnasal approach with endoscopic resection of tumor and the completely endoscopic .technique have less morbidity and a shorter hospital stay than traditional sublabial approaches. Continued follow-up is needed to confirm long-term benefits and similar recurrence rates.

Comparison of endoscopic and microscopic removal of pituitary adenomas: single-surgeon experience and the learning curve

“…Neal et al 29 reported similar trends in complication rates, and overall the complication rate in these series was in the low range for both the microscopic and endoscopic resections. Interestingly, Neal et al found a greater incidence of CSF leaks in the patients with microscopically resected tumors, which was a trend that we did not see.…”

“…There have been a number of case series directly comparing endoscopic and microscopic surgical results by individual surgeons. 3,11,15,23,29,33 We describe our experience in conversion of a cranial base surgery program from traditional methods to the entirely endoscopic method of approach and resection for pituitary lesions. We compare 2 patient cohorts that underwent resection by the same senior neurosurgeon and otorhinolaryngologist (M.S.G.…”

“…In comparison with the sublabial approach, the endoscopic approach minimizes the risks of upper lip and incisor paresthesias. 29 In both sublabial and septal techniques, postoperative nasal packing often leads to discomfort, nasal cavity or septal injury, and sinusitis, all of which are avoided with most endonasal endoscopic techniques. However, endoscopic resection requires the surgeon to trade the binocular, handless microscope for the monocular, more technically challenging endoscope, a technology with which most neurosurgeons are not as familiar.…”

Endocrine Outcome of Endoscopic Endonasal Transsphenoidal Surgery in Functioning Pituitary Adenomas

“…Recent technological advances in specific endoscopic instrumentation, surgical navigation system, and endoscopic image appear to make the EETSA possible as alternative to conventional microscopic TSA. The surgical outcome of EETSA and microscopic TSA showed a wide variability 1,4,11,13,19) . Despite the increasing use of EETSA, however, debates on its surgical outcome, particularly in functioning pituitary adenomas, have been raised by some microscopic pituitary surgeons unfamiliar to EETSA which has some limiting factors such as two-dimensioned image, less zoom and focus capacity, and longer learning curve to microscopic surgeons 1,4,11,13,19) .…”

Evaluación del olfato en pacientes con patología tumoral en la región selar, intervenidos mediante abordaje endoscópico transesfenoidal transnasal

“…Existen reportes en la literatura que comparan el abordaje transnasal endoscópico respecto al abordaje transeptal, mostrando una menor tasa de morbilidad posoperatoria (fístula de LCR, diabetes insípida, uso de drenaje lumbar y dolor) [13][14] , menor tiempo operatorio 5 y menor estadía hospitalaria en el grupo sometido al abordaje transnasal endoscópico [13][14] .…”