With the advancement of science and technology, surgical techniques have also continued to make progress, and how to minimize the trauma and maximize the benefit to the patient is the main direction of the development of surgical techniques. Endoscopic techniques meet the demand for minimally invasive procedures, such as the common cystoscopy, laparoscopy, thoracoscopy, etc. However, one may ask whether endoscopic techniques can also be applied to surgery in the central nervous system, which controls the body’s activities and thinking. The answer is yes, and this is the neuroendoscopic technique. History As early as the beginning of last century, neurosurgical pioneers such as dandy already realized the importance of endoscopy in the field of neurosurgery and introduced endoscopic techniques into the field of neurosurgery, but due to the limitations of the technical conditions at that time, endoscopic equipment was very rudimentary, illumination and image quality were poor, and patient mortality was high, this technique was not well promoted, including the non-neurosurgical field. The take-off of endoscopic technology began with the invention of the columnar lens system, as well as the application of photoelectric conversion systems and optical fiber, which led to a qualitative leap in the quality of images viewed by endoscopy. Doctors can observe clearly in close proximity to the lesion, and with the invention of various surgical instruments, while observing, doctors can perform endoscopic surgery to remove tumors and cure various diseases in a very minimally invasive manner. Compared with conventional surgery, endoscopic techniques are less traumatic and patients recover faster, thus costing less. Indications of neuroendoscopy Our department has been pioneering neuroendoscopic technology since 2009 by Prof. Wu Anhua, who is a member of the expert committee of neuroendoscopy of the Chinese Medical Association, a standing committee member of the expert committee of neuroendoscopic evaluation of the Ministry of Health, and a standing director of the neuroendoscopic committee of the Chinese Association of Endoscopists. So far our department has carried out more than 600 cases of various types of neuroendoscopic surgery. Compared with conventional surgery, patients have shorter operation time, faster recovery, less trauma, easier to find residual tumors and more adequate resection of tumors due to illumination and observation from inside. The neuroendoscopic procedures we perform include: pituitary tumor removal, chordoma removal, cerebrospinal fluid leak repair, nasopharyngeal tumor, all of which are in the category of skull base surgery, and we also perform neuroendoscopic surgery for hydrocephalus. Here we introduce the neuroendoscopic technique with pituitary tumor as an example. The first neuroendoscopic surgery we performed was transnasal pituitary tumor resection. Pituitary tumor is also one of the earlier tumors in history to be resected by neuroendoscopic techniques, and the disease site and pathological characteristics determine that pituitary tumor is one of the most suitable diseases for neuroendoscopic techniques. As the name suggests, pituitary tumors originate from the pituitary gland, which is the endocrine center of the human body. If the human head is viewed as a sphere, the pituitary gland is basically located at the center of this sphere. In addition to its deep location, the site of the pituitary gland is also very important. For those who have not studied medicine, it may be difficult to understand the complex local anatomy. Although the location is deep and the structure is complex, fortunately there is a channel (nasal cavity) in the human head that allows more direct access to the pituitary localization. Another fortunate condition is that most pituitary adenomas are soft (and can be removed by suction), so even through a narrow channel total resection can often be achieved, which is the basis for the currently prevalent microscopic transsphenoidal pituitary tumor resection. However, for more rigid pituitary tumors, or pituitary tumors that grow upward or to the sides, it is often necessary to combine other surgical procedures, or to combine other treatments (e.g., radiation therapy). However, one of the more obvious disadvantages of microscopic pituitary tumor resection is the limited visualization of local structures. With the development of technology, neuroendoscopic techniques have shown increasing superiority in the treatment of pituitary tumors. The main advantage of these techniques is that they can significantly expand the exposure of some of the subtle structures of the pituitary gland, because they can be observed close to the pituitary gland, thus allowing the extent of tumor removal and the relationship between the tumor and the surrounding structures, especially the important structures such as the internal carotid artery, to be observed during surgery. Thus, the tumor can be removed to the maximum extent and damage to important structures can be minimized. Neuroendoscopy is in a sense an extension of the microscope and the surgeon’s field of vision, so it can significantly reduce the damage to the normal structures of the nasal cavity during transnasal surgery, greatly shorten the recovery time and make the surgery safer. However, neuroendoscopic surgery requires a profound understanding of local anatomy (especially endoscopic anatomy) and systematic training in neuroendoscopy to master the skills of neuroendoscopic surgery.