Endoscopic Pituitary Surgery—Our Experience

Background: The direct endonasal trans-sphenoidal approach is the most minimally invasive. Its advantages include wider access, avoidance of a septoplasty, and the ability for two surgeons to work together enabling better instrumentation and more complete and rapid removal of the tumor.

Methods: Our aim was to retrospectively analyze the results of pituitary surgery in 39 consecutive patients' sellar lesions operated in our hospital after the introduction of the endoscopic technique (2001 to 2005). From 2004 we incorporated image-guided surgery, with the fusion of computer tomography and magnetic resonance imaging. The operative morbidity, the duration of surgery, and postoperative complications are discussed.

Results: We had no mortality in our group of patients. Adequate exposure for the degree of resection was achieved in all patients. One patient required revision endoscopic resection 3 years later for tumor recurrence. Transient CSF rhinorrhea was seen in 5 cases; in 1 case was seen tension pneumocephalus complicated by postsurgical infection. Complications included hemorrhage requiring return to the operating room (1 patient) and transient diabetes insipidus (3 patients).

Conclusions: The endoscopic approach to the sellar region is easy, safe, time-saving, and without septal or sublabial complications.