Pituitary Surgery: Transsphenoidal Approach

TLDR

The transsphenoidal approach for sellar tumors has evolved with technological advances and refined patient selection, operative technique, and postoperative care, yet remains non‑standardized due to surgeon preference, experience, and training bias. The authors distill their experience from 3,900 transsphenoidal operations to describe the operative methods and preferences employed.

Abstract

THE TRANSSPHENOIDAL APPROACH for sellar tumors has evolved significantly since it was described initially during the first decade of the 20th century. The approach currently incorporates technological advancements and refinements in patient selection, operative technique, and postoperative care. Although many of these innovations are considered indispensable, the operative technique, as performed by contemporary neurosurgeons, is not standardized. This variability is a reflection of surgeon's preference, the lessons of experience, and the bias inherent in neurosurgical training. The methods and preferences described herein embody the distillation of an experience gained from 3900 transsphenoidal operations.