Endoscopic endonasal transsphenoidal surgery: procedure, endoscopic equipment and instrumentation

Introduction: In the last 10 years the endoscopic endonasal transsphenoidal approach has been proposed as a minimally invasive procedure for the treatment of pathologies of the sellar region. This procedure introduces various advantages compared with the transsphenoidal microsurgical approach such as a wider vision of the surgical field, less traumatism of the nasal structures, greater facility in the treatment of possible recurrences, and reduced complications. Nevertheless, as for any new procedure, there is an initial learning curve that is somewhat steep, due to the necessity of acquiring the specific endoscopic skills. It is equally essential to be supplied with dedicated endoscopic equipment and appropriate surgical instrumentation, in order to optimize the different stages of the operation. Discussion: Therefore, after our extensive experience with over 250 patients treated by means of the endoscopic endonasal transsphenoidal approach for pathologies of the sellar region, we describe herein the characteristics of the proper endoscopic instrumentation, as well as a set of surgical instruments intentionally conceived to respond to the specific characteristics of this new procedure.