LOS ANGELES (June 2, 1999) -- Surgeons at the Skull Base Institute at Cedars-Sinai Medical Center have refined an endoscopic procedure that reduces trauma, decreases risk of complications and speeds recovery for patients who need surgery of the pituitary gland.
The animal study that led to the safe use of the technique in human surgery appears in the April issue of the 'Journal of Laparoendoscopic and Advanced Surgical Techniques.'
The pituitary gland, about the size of a pea and located beneath the brain and behind the nose, produces a variety of hormones and controls most of the hormones in the body. It is situated in a cup-like area of the skull called the sella turcica, behind and above the sphenoid bone.
To remove tumors of the pituitary, surgeons historically have reached the gland by making a hole in the front of the skull or going through the sphenoid bone at the base of the skull. Although the 'transcranial' approach is still sometimes used to remove large tumors, the 'transphenoidal' technique is far more common today.
Surgeons typically make an incision under the upper lip or under a nostril, then use surgical tools to clear a path to and through the sphenoid bone and up to the sella turcica. Once there, they use a high-powered surgical microscope to view the tumor and use microsurgical tools to dissect and remove it.
The introduction and evolution of surgical microscopy over the past several decades has given surgeons a close-up, detailed view of their work. But Hrayr Shahinian, M.D., director of the Skull Base Institute, has found that an endoscopic telescope offers a much better look at the entire area.
Switching between two lenses of different angles, the endoscope can be
manipulated to provide a view of the spaces around the gland to reveal residual
tumor that otherwise might not be detected. The telescopes also give better
definition of the relationships between the pituitary and surrounding
structures. Furthermore, b
Contact: Sandra Van
Cedars-Sinai Medical Center