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Updated: Jun 21, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

A modified speculum for transsphenoidal surgery: technical note.

George Stranjalis¹, Lampis C Stavrinou, Andreas T Kouyialis

¹Department of Neurosurgery, University of Athens, Evangelismos Hospital, Athens, Greece.

Neurosurgical Review

|July 25, 2009

Summary

A modified nasal speculum improves pituitary surgery by increasing clearance and reducing operation time. This enhanced surgical instrument facilitates the transsphenoidal approach for pituitary adenomas.

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Area of Science:

Neurosurgery
Otolaryngology
Surgical Instrumentation

Background:

The transsphenoidal approach is a key technique for pituitary surgery.
Conventional nasal speculums can limit instrument access and visualization.
Improving surgical tools is crucial for patient outcomes.

Purpose of the Study:

To present a modified nasal speculum designed to enhance the translabial-endonasal transsphenoidal approach.
To evaluate the efficacy of the modified speculum in pituitary surgery.

Main Methods:

Modification of a standard nasal speculum by reducing the width of its upper lateral wings.
Performance of 50 transsphenoidal procedures for pituitary adenomas using the modified speculum.
Evaluation of visual field and instrument passage by three experienced surgeons.

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Main Results:

The modified speculum increased interior clearance, facilitating instrument introduction.
Surgeons rated the modified speculum superior to the conventional design for visual field and instrument passage.
A marked reduction in overall operation duration was observed.

Conclusions:

The modified nasal speculum significantly facilitates the transsphenoidal approach to the pituitary.
This instrument modification offers advantages for pituitary adenoma surgery.
Enhanced surgical ergonomics can lead to improved efficiency and potentially better patient outcomes.