Modification of the surgical instruments for endoscopic pituitary tumor resection through the endonasal transsphenoidal approach

Abstract

Objective To modify the surgical instruments to improve the efficiency of endoscopic pituitary tumor resection through the endonasal transsphenoidal approach and sum up the surgical experiences. Methods Two hundred and eighty-eight patients with pituitary tumor were performed endoscopic tumor resection through the endonasal transsphenoidal approach in our hospital from March 2004 to April 2009; modification of the surgical instruments (monopolar coagulator,aspirator's shape and function) was applied. The efficiency of the surgery was concluded and analyzed.Results Total tumor resection was achieved in 204 patients, subtotal tumor resection in 54 and partial resection in 30. The shortest operation time was only 30 minutes and the average operation time in patients without intraoperative CSF leakage was 70 minutes. CSF leakage appeared in 3 patients and delayed hemorrhage of Schneiderian membrane in 3 too, but the symptoms were controled after treatment. Conclusion Modification of the surgical instruments and correct application, together with good operative coordination can improve the efficiency of endoscopic pituitary tumor resection through the endonasal transsphenoidal approach. Key words: Pituitary adenoma; Neuroendoscope; Endonasal transsphenoidal approach; Operative coordination