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Related Experiment Video

Updated: Oct 19, 2025

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

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Neurosurgery Technical Procedure: Surgeon's Position during Microscopic Transsphenoidal Surgery.

Orlando De Jesús1, Alejandro Matos1, Eric Carro1

  • 1Section of Neurological Surgery, Department of Surgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.

Puerto Rico Health Sciences Journal
|September 20, 2021
PubMed
Summary

This study revisits an ergonomic surgeon positioning for transsphenoidal surgery (TSS), with the surgeon standing behind the patient. This approach offers improved comfort and assistant accessibility for microscopic TSS procedures.

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Area of Science:

  • Neurosurgery
  • Surgical Techniques

Background:

  • Transsphenoidal surgery (TSS) surgeon positioning has evolved over time.
  • Current microscopic TSS often involves the surgeon positioned laterally to the patient.

Purpose of the Study:

  • To propose and advocate for a more ergonomic and time-proven surgeon positioning for transsphenoidal surgery.
  • To reintroduce a less commonly discussed surgical setup for microscopic and endoscopic TSS.

Main Methods:

  • The paper describes a surgical setup where the neurosurgeon stands behind the patient's head.
  • The microscope tower is positioned on the surgeon's back, a technique used since the early 1980s.

Main Results:

  • This posterior surgeon positioning is considered more comfortable for the operating surgeon.
Keywords:
MicrosurgeryPituitaryPositionSurgeonTechnicalTranssphenoidal

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  • The setup facilitates closer proximity and better assistance from the surgical team.

    • Conclusions:

    • The posterior surgeon positioning offers ergonomic benefits for microscopic transsphenoidal surgery.
    • This technical note aims to provide novel insights for surgeons utilizing microscopic TSS, including residents and those performing endoscopic procedures.