Endoscopic surgery for pituitary tumors.

The endoscopic transsphenoidal approach to the sella turcica has been developed and refined for the treatment of pituitary lesions. Studies comparing endoscopic transsphenoidal surgery with the traditional microscopic transsphenoidal technique have found equivalent or improved rates of tumor resection and hormonal remission, and equal or lower rates of complications. This procedure affords improved panoramic visualization, illumination, surgical freedom, and mobility. This approach facilitates two-handed microdissection and the ability to look around corners using angled lenses, promoting maximal tumor resection and preservation of the pituitary gland. Experience, technologic advancements, and improved instrumentation are likely to contribute to improved surgical outcomes.