Abstract
Trans-sphenoidal surgery, which is the most widely used technique for the treatment of pituitary tumors, has continued to evolve by introducing new approaches and technologies, such as the direct endonasal route and the endoscope. The endonasal approach is a minimally invasive route to the sella turcica with the advantages of using a simpler and more rapid nasal dissection and eliminating the nasal and lip complications. Restricted exposure provided by the endonasal approach is overcome by combined use of an endoscope that provides a more panoramic view of the surgical field beyond the area covered by the operating microscope. An operating microscope permits binocular vision and bimanual technique, which are familiar to neurosurgeons. Neurosurgeons should exploit the advantages of both modalities for the benefit of patients. This review describes the advances in trans-sphenoidal surgery focusing on the endoscopic approach.
Published Version
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