Combined Microsurgical-, Endoscopic-, and Neuronavigation-Assisted Transsphenoidal Resection of Pituitary Tumors: Our Experience

The transsphenoidal microsurgical resection has been long established as a “gold standard” treatment for pituitary tumors. It provides the magnification, the illumination, the three-dimensional visualization, the communication among operation room personnel, and the education tool for trainees via a real-time direct observation of the screen or viewing the operation after recording it. More recently, endoscopic-assisted transsphenoidal pituitary tumor resection has been gaining popularity claiming to be “less invasive,” able to see around different angles (“around the corner view”), and providing shorter patient length of stay (LOS) in the hospital. In addition, neuronavigation has well-established role in improving preciseness and radicality in resection of brain tumors. In an attempt to gain advantages of all three techniques, we have combined them into one in an attempt to achieve a radical and safe resection of pituitary tumors.

Utilizing this combined technique, we have operated 54 patients. The details of demographics, clinical presentations, histology, radiological appearances, LOS, and outcomes will be analyzed. The combined benefits yielded using these three techniques will be highlighted.