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Updated: Jul 1, 2025
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Endoscopic Endonasal Trans-Sphenoidal Minimally Invasive Pituitary Surgery with Image Guided Navigation System
Debasish Ghosh1, Srikrishna Majhi2, Ankit Choudhary1
1Department of ENT, IORL &HNS, Institute of Post Graduate Medical Education and Research, 700020 Kolkata, India.
Summary
Image guided navigation system (IGNS) enhances endoscopic minimally invasive pituitary surgery (MIPS) for pituitary adenomas. This study shows IGNS improves surgical precision and disease clearance rates, aiding in better patient outcomes.
Area of Science:
- Neurosurgery
- Endocrinology
- Medical Imaging
Background:
- Endoscopic minimally invasive pituitary surgery (MIPS) offers advantages over traditional microscopic techniques due to enhanced visualization.
- Image guided navigation systems (IGNS) are increasingly utilized to improve the precision of surgical localization.
Purpose of the Study:
- To analyze the procedural outcomes of endoscopic MIPS guided by IGNS for pituitary adenomas.
- To evaluate disease clearance rates and patient outcomes in a series of pituitary adenoma surgeries.
Main Methods:
- A retrospective review of 98 patients with pituitary adenomas who underwent endoscopic MIPS between April 2015 and August 2022.
- Data analysis included disease clearance, hormonal recovery, and complications, with statistical review of outcomes.
Main Results:
- Total disease clearance was achieved in 85 out of 98 cases (86.7%) as confirmed by postoperative MRI.
- Postoperative hypopituitarism occurred in one patient with normal preoperative hormone levels; 66.6% of patients with preoperative hypopituitarism showed recovery.
- Macroadenomas and giant adenomas presented a higher risk for incomplete disease clearance.
Conclusions:
- Image guided navigation systems (IGNS) augment endoscopic visualization, providing real-time stereotactic feedback for enhanced accuracy and safety in MIPS.
- While IGNS requires setup time, it significantly increases the precision, safety, and effectiveness of minimally invasive pituitary surgery.
- The study highlights the benefits of IGNS in achieving high rates of disease clearance and improving patient outcomes for pituitary adenomas.
