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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Endoscopic endonasal transsphenoidal surgery: a mentoring surgical model
Joseph Y M Yang1, Ingrid De Ruiter, Andrew Parker
1Department of Neurosurgery, Wellington and Wakefield Hospitals Endoscopic Sinus and Skull Base Surgery, Wakefield Hospital, Wellington, New Zealand.
ANZ Journal of Surgery
|May 11, 2012
Summary
A collaborative mentoring surgical model facilitated successful endoscopic endonasal transsphenoidal surgery (EETS) for pituitary tumors. This approach enabled a smaller center to achieve excellent outcomes during the learning phase.
Area of Science:
- Neurosurgery
- Endoscopic Skull Base Surgery
Background:
- Endoscopic endonasal transsphenoidal surgery (EETS) is a key technique for pituitary region tumor resection.
- Wellington, New Zealand's central neurosurgery referral center, adopted EETS.
- A collaborative mentoring surgical model was implemented to enhance the learning experience.
Purpose of the Study:
- To report the experience of EETS for pituitary region tumors at a central referral center.
- To discuss the effectiveness of a collaborative mentoring surgical model in improving surgical outcomes and learning.
- To evaluate the feasibility of adopting EETS in a smaller endoscopic skull base unit.
Main Methods:
- Retrospective review of 47 EETS operations on 46 patients (January 2007 - June 2009).
- Involved perioperative clinical assessment, hormonal profiling, and MRI for residual disease.
- Utilized a collaborative model with experienced neurosurgeons and visiting endoscopic skull base rhinologists.
Main Results:
- Pathologies included pituitary adenomas (functioning and non-functioning), meningiomas, chordoma, adenocarcinoma, and metastasis.
- Complete tumor resection was achieved in 38 cases.
- Positive outcomes included hormonal profile improvement in secreting adenomas and vision improvement in 19/27 cases. Perioperative complications were noted.
Conclusions:
- The collaborative mentoring model proved valuable for centers adopting EETS.
- Excellent EETS outcomes are achievable in smaller Australasian endoscopic skull base units during the learning phase.
- This model supports the successful integration of advanced surgical techniques.
