Apple Vision Pro-Enabled Endoscopic Endonasal Approach for Pituitary Adenoma Resection: First In-Human Spatial Computing Skull Base Neurosurgery Case Report.

Objective This study aimed to report the first in-human skull base neurosurgery case using Apple Vision Pro (AVP). Main Outcome Measures Endoscopic stream with the AVP in an endoscopic endonasal transsellar and left transcavernous approach for resection of a pituitary adenoma. Results Endoscopic endonasal approach was performed using the AVP for resection of a pituitary adenoma. The procedure was completed without complication. A postoperative magnetic resonance imaging (MRI) showed no convincing residual pituitary mass. The patient was discharged on postoperative day 2. Conclusion Endoscopic streaming to the AVP is safe in skull base surgery. We described the first case report of an AVP-specific spatial computing technology successfully used to display endoscopic feed to the skull base neurosurgeon during skull base neurosurgery with no intraoperative complications. Continued integration of intraoperative navigation platforms, patient vitals, preoperative imaging, and electronic medical records with endoscopic streams serves as an important step in optimizing surgeon experience and developing a virtual operating room.