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Related Experiment Video

Updated: Nov 11, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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A Novel Technique for Transpalatal Hypophysectomy.

Ilton Guenhiti Shinzato1,2, Felipe Bouchabki de Almeida Guardini1,3,4, Herbert de Abreu Cavalcanti1

  • 1Hospital Santa Casa de Campo Grande, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil.

Journal of Neurological Surgery. Part B, Skull Base
|March 29, 2021
PubMed
Summary

A novel transpalatal hypophysectomy technique offers a safe and effective surgical option for sellar region tumors, minimizing patient discomfort and complications. This approach provides direct visualization for large suprasellar tumors.

Keywords:
endoscopic surgerypituitary adenomaskull-base surgerytransoral robotic-assisted surgerytranspalatal corridortranssphenoidal hypophysectomy

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Area of Science:

  • Neurosurgery
  • Endoscopic Surgery
  • Sellar Region Tumors

Background:

  • Transsphenoidal hypophysectomy is a conventional approach for pituitary tumors.
  • Large suprasellar tumors can pose surgical challenges with existing techniques.

Purpose of the Study:

  • To describe a novel transpalatal hypophysectomy technique.
  • To evaluate its safety and efficacy for sellar region surgery.

Main Methods:

  • A straight submucosal tunnel approach was developed for microscope and/or endoscope use.
  • This technique facilitates direct visualization of large suprasellar tumors, including those with extra-axial expansion.

Main Results:

  • Over 50 patients were treated over 25 years.
  • Total excision of macroadenomas was achieved in 76.5% of cases.
  • Low complication rates were observed, with no severe hemorrhage, CSF leaks, or visual impairment.

Conclusions:

  • The transpalatal hypophysectomy is a safe and effective surgical option.
  • Patients experience low discomfort and rare sequelae.
  • Further research with advanced equipment is recommended for comparative analysis.