Enter your Email address:
Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
You currently have no recent searches
Laws, Edward R. Jr.
The provocative letter of Drs. de Divitiis and Cappabianca highlights a number of points relevant to technical advances in neurosurgery. These points include the relative virtues of endoscopic transsphenoidal pituitary surgery as compared with the standard approach with the binocular operating microscope, methods of teaching trainees new technical advances such as endoscopic neurosurgery, the relative advantages and disadvantages of each technique for the patient with regard to comfort, and the entire concept of minimally invasive surgery.
It is important to remember that the goal of pituitary surgery is not to have the patient leave the hospital the same day or the next day but to achieve effective removal of the offending lesion. At this point, it is not really known whether an experienced surgeon who uses endoscopic techniques for pituitary surgery can match the outcome results achieved with standard transsphenoidal microsurgery. The published case series and follow-up periods simply have not been adequate to make this determination in a scientific fashion. Surely, the efficacy of endoscopic techniques eventually will be determined, but definitive results probably will not be available for several years. In acknowledging this fact, however, one must be impressed by the several technical and conceptual advantages offered by the endoscopic approach. In my opinion, the advantages are compelling enough to permit me to state that every neurosurgical resident should be trained in the effective use of the operating endoscope. If this training is provided, it is nearly certain that younger neurosurgeons and neurosurgeons in training will extend the use of the endoscope to appropriate areas, which surely will include transsphenoidal pituitary surgery. Whether they should start using the endoscope immediately is a matter of debate. My suspicion is that the use of the endoscope in neurosurgery will eventually parallel the adoption of this instrumentation and conceptual methodology by general surgeons. This evolution will be even more certain when endoscopes provide a three-dimensional view, are easily kept clean, or are replaced by miniature television cameras. Drs. de Divitiis and Cappabianca have been among the pioneers in advocating for the more widespread adoption of the endoscopic technique for pituitary surgery, showing an intelligent approach and vigor in the desire to educate others in the use of these techniques (1).
Edward R. Laws Jr.
Copyright © by the Congress of Neurological Surgeons
Colleague's E-mail is Invalid
Your Name: (optional)
Separate multiple e-mails with a (;).
Thought you might appreciate this item(s) I saw at Neurosurgery.
Send a copy to your email
Your message has been successfully sent to your colleague.
Some error has occurred while processing your request. Please try after some time.
An Existing Folder
A New Folder
The item(s) has been successfully added to "".
Login with your LWW Journals username and password.
Username or Email:
Enter and submit the email address you registered with. An email with instructions to reset your password will be sent to that address.
Link to reset your password has been sent to specified email address.
What does "Remember me" mean?
By checking this box, you'll stay logged in until you logout. You'll get easier access to your articles, collections,
media, and all your other content, even if you close your browser or shut down your
To protect your most sensitive data and activities (like changing your password),
we'll ask you to re-enter your password when you access these services.
What if I'm on a computer that I share with others?
If you're using a public computer or you share this computer with others, we recommend
that you uncheck the "Remember me" box.
Save my selection
Article Level Metrics