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Updated: Nov 9, 2025
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Endoscopic extra-capsular resection of a giant pituitary adenoma: how I do it
Aristotelis Kalyvas1, Matthias Millesi1, Fred Gentili2
1Division of Neurosurgery, Toronto Western Hospital/University Health Network, University of Toronto, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.
Background:
Giant pituitary adenomas are characterized by their large size and potential to invade parasellar and suprasellar regions leading to visual decline and hypopituitarism. Thus, they remain a significant surgical challenge, and gross total removal is only achieved in the minority of cases.
Method:
We aim to describe the key surgical steps for endoscopic extra-capsular resection of a giant pituitary adenoma with the aim of achieving complete tumor resection with description of the relevant surgical anatomy, indications and limitations.
Conclusion:
Endoscopic extra-capsular resection of giant pituitary tumors when feasible allows for complete tumor resection, early identification of the gland and avoidance of manipulation of the optic apparatus.
