CHANDIGARH,23.10.20-"In a first of its kind, endoscopic skull base surgeons led by Dr. Dhandapani SS, and Dr. Ninad from Deptt. of Neurosurgery, PGIMER have shown how the use of advanced neurosurgical gadgets can improve the outcome of endoscopic surgery for pituitary tumours. The results are published in “Neurosurgical Review,” one of the premier journals.

The pituitary is the ‘master gland’ of our body, controlling several hormone glands such as thyroid, adrenal, and sex organs. Pituitary tumours are the most challenging of neuroendocrinological issues faced by neurosurgical patients. Being close to the nerves carrying vision from the eyes to the brain, these often decrease vision and sometimes blindness. They can either secrete too much or result in too little hormones. As a result, there can be problems ranging from obesity, diabetes mellitus, sexual dysfunction, tiredness, and sometimes coma.

Sometime back, microscopic surgery through the nose was the standard. Over the last one or two decades, endoscopic surgery has become increasingly popular. Endoscopy through the nose had several advantages, such as fewer complaints of nose and sinuses. Some of the large pituitary tumors were still difficult to operate. Recently neuronavigation was introduced for better precision during neurosurgery for complex tumors. Surgical navigation is a computerized technology to Vandoeuvre precisely and identify targets similar to GPS in mobile devices. Also, angled endoscopes could help surgeons see the tumor portions in crucial areas, like a periscope.

Though these tools are being used widely, there has not been adequate proof of their actual efficacy. The study led by Dr. Dhandapani SS is the first to show that navigation and angled endoscopes help a good surgeon deliver even better results. Navigation was helpful during surgery in almost half of the cases. The tumor resection rates improved from 71% to 87%, and the re treatment rates decreased from 21% to 8% with navigation. In complex hormone-secreting tumors, the cure rate improved from 0% to 69% using navigation. Angled endoscopes were helpful in additional tumor removal in 63% of cases. In non-secreting tumors, angled endoscopes improved resection rates from 71% to 92%, and re treatment rates decreased from 16% to 0%.

Notably, Dr. Dhandapani’s team in PGIMER had also previously pioneered many new developments in minimally invasive endoscopic brain and spine surgery. The latest publication on endoscopic endonasal surgery adds a new feather in their cap of laurels."