Endoscopic Endonasal Transsphenoidal Approach to the Sella: Towards Functional Endoscopic Pituitary Surgery (FEPS)*

TLDR

Standard microscopical transsphenoidal surgery is used worldwide for most sellar lesions, yet ongoing technological advances leave room for improvement. The authors aim to evaluate the advantages and limitations of a modified endoscopic endonasal transsphenoidal technique and propose the term Functional Endoscopic Pituitary Surgery (FEPS) to describe this minimally invasive, one‑nostril approach. They employed a slightly modified Jho‑Carrau technique for endoscopic endonasal transsphenoidal removal of pituitary lesions. The technique was applied to 15 consecutive patients with successful outcomes, and preliminary results are reported.

Abstract

Standard microscopical transsphenoidal surgery is used world-wide in most sellar lesions, but continuing technological progress leaves room for further possibilities. The authors have employed a slightly modified Jho-Carrau technique for endoscopic endonasal transsphenoidal removal of pituitary lesions. This approach has been successfully used in 15 consecutive patients; the preliminary results are reported. The advantages and the limitations of this technique are discussed and compared to standard transsphenoidal surgery. In consideration of the low invasiveness of this approach and of the improved respect for the inner nose and sinus structures, the authors suggest the new term of Functional Endoscopic Pituitary Surgery (FEPS) to characterize this simple one-nostril endoscopic endonasal procedure.