Pituitary gland is the endocrine gland of human body. Once a tumor appears, even if the lesion is small, it will lead to hormonal disorder due to the involvement of endocrine system, which will seriously affect the quality of life. Pituitary tumor is the second most prevalent tumor in the cranium, with a combined incidence of nearly 1/1000 in the population. Because pituitary tumor is deep in the base of the brain, it is more difficult to operate, especially invasive pituitary tumor. In the past, most pituitary tumors were operated by microscopic surgery, in which the nasal cavity was opened by special instruments and the pituitary tumor was operated under direct vision with the help of an operating microscope. Due to the limitation of light path, the tumor can only be seen within a limited range under the microscope, and if the tumor is beyond the field of view, sometimes the surgeon can only operate outside the field of view with a spatula based on his experience.
When endoscopic technique is used for pituitary tumor resection, the thin endoscope is directly inserted into the nasal cavity for imaging, which can have a closer depth of field and wider view than the microscope, and can clearly display even some remote and folded locations. Moreover, since endoscopic surgery does not require the use of retractors, the normal structure of the nasal cavity is protected, with less trauma and less postoperative pain. In addition, endoscopic surgery is operated completely under direct vision, which facilitates the complete removal of tumor and the protection of normal pituitary tissues, resulting in faster recovery of pituitary function and better therapeutic effect after surgery.
Endoscopic imaging extends the field of view of the surgery, but the placement of the endoscope in the small nostril and the simultaneous placement of suction, scrapers, hooks and even drills require high technical skills of the surgeon and endoscopic imaging equipment.