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Updated: Apr 28, 2026

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

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

Published on: January 17, 2018

[Endoscopic Combined Transcranial and Endonasal Approach].

Tadashi Watanabe¹

¹Department of Neurosurgery, Aichi Medical University.

No Shinkei Geka. Neurological Surgery

|April 27, 2026

Summary

This summary is machine-generated.

This study presents a combined endoscopic keyhole and transnasal surgery approach for complex pituitary tumors. This technique aims to improve resection of giant pituitary neuroendocrine tumors and reduce bleeding complications.

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Last Updated: Apr 28, 2026

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Published on: August 15, 2025

Area of Science:

Neurosurgery
Endocrinology
Oncology

Background:

Surgical treatment of massive sellar lesions, especially giant pituitary neuroendocrine tumors, presents significant risks.
Bleeding from residual tumor tissue is a major clinical challenge in these cases.
Tumors extending laterally or invading brain parenchyma require advanced surgical strategies.

Purpose of the Study:

To describe a combined endoscopic keyhole and transnasal surgery approach for challenging pituitary tumors.
To detail the technique, its practical application, and variations for difficult resections.
To address limitations of single-corridor approaches in complex sellar lesion surgery.

Main Methods:

A combined surgical technique utilizing both endoscopic keyhole and transnasal corridors.
Application for tumors extending beyond the internal carotid artery or invading brain parenchyma/ventricles.
Detailed explanation of surgical steps and variations.

Main Results:

The combined approach facilitates resection in cases where single-corridor surgery is difficult.
Potential for improved tumor removal in complex anatomical situations.
Management of bleeding from residual tumor tissue is addressed.

Conclusions:

The combined endoscopic keyhole and transnasal approach offers a viable solution for complex pituitary tumors.
This technique enhances surgical possibilities for laterally extending or deeply invading lesions.
Careful planning and execution are crucial for managing risks associated with these challenging tumors.