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Endoscopic endonasal transsphenoidal surgery: procedure, endoscopic equipment and instrumentation

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Abstract

Introduction

In the last 10 years the endoscopic endonasal transsphenoidal approach has been proposed as a minimally invasive procedure for the treatment of pathologies of the sellar region. This procedure introduces various advantages compared with the transsphenoidal microsurgical approach such as a wider vision of the surgical field, less traumatism of the nasal structures, greater facility in the treatment of possible recurrences, and reduced complications. Nevertheless, as for any new procedure, there is an initial learning curve that is somewhat steep, due to the necessity of acquiring the specific endoscopic skills. It is equally essential to be supplied with dedicated endoscopic equipment and appropriate surgical instrumentation, in order to optimize the different stages of the operation.

Discussion

Therefore, after our extensive experience with over 250 patients treated by means of the endoscopic endonasal transsphenoidal approach for pathologies of the sellar region, we describe herein the characteristics of the proper endoscopic instrumentation, as well as a set of surgical instruments intentionally conceived to respond to the specific characteristics of this new procedure.

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References

  1. Cappabianca P, de Divitiis E (2004) Endoscopic pituitary surgery. Endo-Press, Tuttlingen, p 66

  2. Cappabianca P, Alfieri A, de Divitiis E (1998) Endoscopic endonasal transsphenoidal approach to the sella: towards functional endoscopic pituitary surgery (FEPS). Minim Invasive Neurosurg 41:66–73

    CAS  PubMed  Google Scholar 

  3. Cappabianca P, Alfieri A, Thermes S, Buonamassa S, de Divitiis E (1999) Instruments for endoscopic endonasal transsphenoidal surgery. Neurosurgery 45:392–396

    Article  CAS  PubMed  Google Scholar 

  4. Cappabianca P, Alfieri A, Colao A, Cavallo LM, Fusco M, Peca C, Lombardi G, de Divitiis E (2000) Endoscopic endonasal transsphenoidal surgery in recurrent and residual pituitary adenomas. Technical note. Minim Invasive Neurosurg 43:38–43

    Article  CAS  PubMed  Google Scholar 

  5. Cappabianca P, Alfieri A, de Divitiis E, Tschabitscher M (2001) Atlas of endoscopic anatomy for endonasal intracranial surgery. Springer, Berlin Heidelberg New York, p 134

  6. Cappabianca P, Cavallo LM, Mariniello G, de Divitiis O, Becerra Romero ADC, de Divitiis E (2001) Easy sellar reconstruction in endoscopic transsphenoidal surgery with polyester-silicone dural substitute and fibrin glue: technical note. Neurosurgery 49:473–476

    CAS  PubMed  Google Scholar 

  7. Cappabianca P, Cavallo LM, Colao A, Del Basso De Caro M, Esposito F, Cirillo S, Lombardi G, de Divitiis E (2002) Endoscopic endonasal transsphenoidal approach: outcome analysis of 100 consecutive procedures. Minim Invasive Neurosurg 45:1–8

    Article  PubMed  Google Scholar 

  8. Cappabianca P, Cavallo LM, Colao A, de Divitiis E (2002) Surgical complications of the endoscopic endonasal transsphenoidal approach for pituitary adenomas. J Neurosurg 97:293–298

    PubMed  Google Scholar 

  9. Cappabianca P, Cavallo LM, Esposito F, Valente V, de Divitiis E (2002) Sellar repair in endoscopic endonasal transsphenoidal surgery: results of 170 cases. Neurosurgery 51:1365–1372

    PubMed  Google Scholar 

  10. De Divitiis E, Cappabianca P (2002) Endoscopic endonasal transsphenoidal surgery. In: Pickard JD (ed) Advances and technical standards in neurosurgery, vol 27. Springer, Berlin Heidelberg New York, pp 137–177

  11. De Divitiis E, Cappabianca P (2003) Endoscopic endonasal transsphenoidal surgery. Springer, ,Berlin Heidelberg New York, p 198

  12. De Divitiis E, Cappabianca P, Cavallo LM (2002) Endoscopic transsphenoidal approach: adaptability of the procedure to different sellar lesions. Neurosurgery 51:699–707

    PubMed  Google Scholar 

  13. De Divitiis E, Cappabianca P, Laws ER Jr (2002) Microscopic and endoscopic transsphenoidal surgery. Neurosurgery 51:1527–1530

    PubMed  Google Scholar 

  14. Frank G, Pasquini E (2002) Endoscopic endonasal approaches to the cavernous sinus: surgical approaches. Neurosurgery 50:675

    PubMed  Google Scholar 

  15. Frank G, Pasquini E (2003) Approach to the cavernous sinus. In: de Divitiis E, Cappabianca P (eds) Endoscopic endonasal transsphenoidal surgery. Springer, Berlin Heidelberg New York, pp 159–175

  16. Jho HD (1999) Endoscopic surgery of pituitary adenomas. In: Krisht AF, Tindall GT (eds) Comprehensive management of pituitary disorders. Lippincott Williams & Wilkins, Hagerstown, pp 389–403

  17. Jho HD (2000) Endoscopic transsphenoidal surgery. In: Schmidek HH (ed) Schmidek and sweet operative neurosurgical techniques. Indications, methods and results. Saunders, Philadelphia, pp 385–397

  18. Jho HD (2001) Endoscopic endonasal approach to the optic nerve: a technical note. Minim Invasive Neurosurg 44:190–193

    Article  CAS  PubMed  Google Scholar 

  19. Jho HD, Carrau RL (1997) Endoscopic endonasal transsphenoidal surgery: experience with 50 patients. J Neurosurg 87:44–51

    CAS  PubMed  Google Scholar 

  20. Jho HD, Carrau RL, Mc Laughlin ML, Somaza SC (1996) Endoscopic transsphenoidal resection of a large chordoma in the posterior fossa. Neurosurg Focus 1:1–7

    Google Scholar 

  21. Lasio G, Ferroli P, Felisati G, Broggi G (2002) Image-guided endoscopic transnasal removal of recurrent pituitary adenomas. Neurosurgery 51:132–137

    PubMed  Google Scholar 

  22. Leonhard M, Cappabianca P, de Divitiis E (2003) The endoscope, endoscopic equipment and instrumentation. In: de Divitiis E, Cappabianca P (eds) Endoscopic endonasal transsphenoidal surgery. Springer, Berlin Heidelberg New York, pp 9–19

  23. Tasman AJ, Feldhusen F, Kolling GH, Hosemann W (1999) Video-endoscope versus endoscope for paranasal sinus surgery: influence on visual acuity and color discrimination. Am J Rhinol 13:7–10

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Neurosurgery, Department of Neurological Sciences, Federico II University, Via S. Pansini 5, Naples, 80131, Italy

    Paolo Cappabianca, Luigi Maria Cavallo, Felice Esposito & Enrico de Divitiis

Authors
  1. Paolo Cappabianca
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  2. Luigi Maria Cavallo
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  3. Felice Esposito
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  4. Enrico de Divitiis
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Corresponding author

Correspondence to Paolo Cappabianca.

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Cappabianca, P., Cavallo, L.M., Esposito, F. et al. Endoscopic endonasal transsphenoidal surgery: procedure, endoscopic equipment and instrumentation. Childs Nerv Syst 20, 796–801 (2004). https://doi.org/10.1007/s00381-004-0933-3

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  • DOI: https://doi.org/10.1007/s00381-004-0933-3

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