Robotic Exoscopic Resection of Pituitary Tumors

Abstract

Background Surgical strategies to approach anterior skull base and pituitary pathology through transnasal corridors was originally made possible in a safe and efficacious manner due to the magnification and illumination afforded by the operating microscope. Technical advancements in optics, illumination, and miniaturization led to the mainstream use of endoscopes for the transnasal corridor. Advances continue to be made leading to experimentation with 3D endoscopes that are now used at a few select centers. Further developments in surgical visualization have led to the use of exoscopes in lieu of the operating microscope for cranial surgery but have not been adopted in anterior skull base surgery through a transnasal corridor. We describe our initial experience in using an exoscope, mounted to a robotic arm to assist in the resection of pituitary tumors through a transnasal corridor.