Transition From Microscopic to Endoscopic Transsphenoidal Surgery: Challenges, Advantages, and Early Surgical...

Area of Science:

• Neurosurgery
• Endoscopic Surgery
• Pituitary Tumors

Background:

• The transition from microscopic transsphenoidal surgery to endoscopic endonasal techniques is evolving.
• Evaluating early outcomes is crucial for adopting new surgical approaches.

Purpose of the Study:

• To assess the initial clinical and surgical results of adopting the endoscopic endonasal transsphenoidal approach.
• To compare outcomes during the learning curve phase.

Main Methods:

• Retrospective analysis of the first 10 patients undergoing endoscopic endonasal transsphenoidal surgery.
• Procedures performed by a multidisciplinary team with prior microscopic surgery experience.
• Evaluation of tumor characteristics, resection extent, complications, and clinical outcomes.

Main Results:

• Eight of ten patients achieved gross total resection of pituitary tumors.
• Three patients experienced intraoperative cerebrospinal fluid leakage; one required fistula repair.
• No major vascular complications occurred; one patient developed permanent diabetes insipidus.

Conclusions:

• The endoscopic endonasal transsphenoidal approach yields acceptable early surgical outcomes.
• Patient selection and a multidisciplinary team are key to successful implementation.
• The endoscopic technique can be safely introduced during the early learning curve.