[Transsphenoidal surgery for large and giant pituitary adenomas by intraoperative video endomonitoring]

The paper analyzes the outcomes of surgical treatment of patients with pituitary adenomas on the basis of 614 performed transsphenoidal surgical appliances, of which there were 209 large and giant pituitary adenomas. The use of intraoperative video endomonitoring during these interventions could substantially reduced the number of complications, enhance the radicalism and selectivity of a surgical appliance. By using such advantages as endoscopy as powerful lighting, an endomicroscopic phenomenon, and a lateral view, at surgery we could precisely determine the borders of an adenoma, the site and sizes of non-removed tumors fragments. The lateral view of an endoscope permits removal of a tumor via the optimal access, prevention of traumatization of cerebral structures and the contents of cavernous sinuses. If there is intraoperative liquorrhea, the latter can be verified and eliminated. Thus, the accumulated experience allows the authors to recommend using intraoperative video endomonitoring during transsphenoidal surgery for pituitary adenomas.