Adapting the use of a small fiberoptic-like catheter shaped tool called an endoscope, a surgical procedure has been developed that not only eliminates the need for nasal packing but heightens the surgeon's visualization of pituitary tumors. Replacing the operating microscope, the endoscope provides the surgeon with a panoramic view of the pituitary gland and surrounding structures. It can also provide a very close view of the pituitary gland and tumor interface. The patient undergoes general anesthesia, the endoscope and surgical instruments are placed in the patient's nostril, and the tumor is removed. No lip or nasal incisions are made, no packing is placed, and patients are generally sent home the day after surgery.
Patients can also usually return to work or school in four to six weeks time.
Images Schematic drawings demonstrate techniques of endoscopic pituitary surgery. A transphenoidal retractor is not used. No skin or mucosal incisions are required. No postoperative nasal packing is necessary. After completion of tumor removal, the sella is reconstructed with auotgenous bone that was preserved at the time of sphenoidotomy.