The Fully Endoscopic Endonasal Approach

Abstract

This chapter describes the fully endoscopic endonasal, also called transnasal, approach. The advantages of the endoscopic endonasal approach include more thorough tumor resection, fewer surgical complications, elimination of unnecessary steps, and reductions in operative and hospitalization times. These advantages have rendered the fully endoscopic endonasal approach the “gold standard” in pituitary surgery. In our practice, the fully endoscopic endonasal approach has improved our ability to achieve complete resection of pituitary and other sellar tumors. This chapter's description of the approach includes indications, operating room setup, patient positioning, operative technique, state-of-the-art illustrative cases (including a clinical background on the most important pathologies in this area), potential complications, and ways to avoid these complications (in the authors’ experience).