Minimally invasive, fast and efficient – neuroendoscopic pituitary tumor removal Mr. Fu was 37 years old and in the prime of his career when he was found to have pituitary adenoma due to vision loss. Since the vision loss was caused by the compression of pituitary tumor, the tumor had to be removed surgically to improve the vision. In November of last year, he underwent his first pituitary tumor removal at a local hospital in Jiangsu. However, for various reasons, the tumor was only partially removed during the first surgery, and his vision returned to its pre-operative state after a short period of improvement. So, in March this year, Mr. Fu came to a big hospital in Shanghai with hope to receive the second surgery. After the operation, the doctor told him that the tumor had a tough texture and a large part of it remained despite the efforts. After listening to the doctor’s words, Mr. Dai thought that he was so young, what should he do if the tumor recurred in the future? Therefore, Mr. Dai, who was always optimistic, became depressed, especially in July this year, Mr. Fu’s vision dropped again. His family members were anxious to see him and asked around if there was a good doctor who could treat his disease. Later, they heard that the neurosurgery department of Shanghai Tenth People’s Hospital affiliated with Tongji University had a solution, so Mr. Fu, who was eager to seek medical help, found Professor Lou Meiqing with the psychology of trying. Prof. Lou organized a case discussion and decided to remove the tumor through neuroendoscopy. The operation was a great success and the tumor was all removed! After Mr. Fu heard about it, he was excited beyond words. He was able to get out of bed and eat normally on the first day after the operation, and on the fourth day after the operation, he was discharged from the hospital. After he was discharged, his friends and neighbors around him did not believe that he had surgery because, at all, he could not find any wound on his head. Mr. Weng is also a pituitary tumor patient. The tumor was found a year ago, but he didn’t take it seriously until he later realized the seriousness of the problem when his sexual function was progressively diminished and his eyesight also decreased. After he came to a famous hospital in Shanghai by name, the doctor told him that the tumor grew aggressively to the lateral side and completely encircled the lateral internal carotid artery, the conventional transnasal microscopic surgery to remove it was risky and difficult, Mr. Weng was afraid to do the surgery after hearing about it. Later, he heard that there was a new method in the neurosurgery department of Shanghai Tenth People’s Hospital, so he came to our neurosurgery department for consultation. Professor Lou also used neuroendoscopy to remove the tumor completely. For such a case, Prof. Lou Meiqing explained that because the tumor wrapped around the internal carotid artery, if traditional microscopic surgery was used, part of the tumor would not be visible, and if removed blindly would face the risk of hemorrhage from carotid artery rupture. Pituitary tumor is a benign intracranial tumor growing in the endocrine cells of pituitary gland. Its harm is mainly manifested in two aspects: First, it secretes too much hormone, causing hormone-related symptoms, such as menstrual disorder, amenorrhea, infertility and lactation in women, and impotence, hypogonadism and infertility in male patients. If adults develop acromegaly and children or adolescents develop gigantism, it should also be highly suspected that it is due to pituitary glandular durations. Secondly, the tumor grows up and compresses the surrounding nerves and blood vessels, most commonly the optic nerve, causing vision loss, visual field defects, and even blindness. The aforementioned Mr. Fu belongs to this case. Since most pituitary tumors are benign, if detected early and treated correctly, they can be cured or their symptoms can be significantly improved. The treatment of pituitary tumors is mainly based on surgery. The majority of hospitals currently use microscopic transnasal surgery. This method requires the nasal cavity to be filled for 2-3 days after surgery, which is more painful for patients. In addition, the field of view under the microscope is narrow and fixed, and the tumor growing in the periphery cannot be seen directly, and can only be removed by the surgeon’s hand, so not only is total excision difficult, but also there is considerable risk. Neuroendoscopic transsphenoidal pituitary tumor resection is a newly developed advanced technique in recent years. This surgical approach overcomes the inherent defects of microscopic surgery and provides a clear panoramic image of the surgical area, which can clearly display the tumor and the surrounding important structures in all directions, thus maximizing the removal of the tumor and minimizing the damage to the normal nerve tissue. In addition, the tiny endoscope uses the natural gap of the nasal cavity as a surgical channel, which causes almost zero damage to the nasal cavity. Therefore, the nasal cavity does not need to be filled after surgery, and the patient feels comfortable, and the patient’s hospital stay is also significantly shortened, and the patient can generally be discharged from the hospital 3 days after surgery. The neurosurgery department of Shanghai Tenth People’s Hospital led by Prof. Lou Meiqing is one of the first units to carry out such surgery in Shanghai, and has completed nearly 500 pituitary tumor surgeries, using the most advanced endoscopic resection of pituitary tumors in more than 120 cases, and has achieved excellent results, and holds a continuing education class on endoscopic pituitary tumor surgery in Shanghai once a year to popularize the advanced technology.