Advances in pituitary surgery

In this paper, the pertinent advances in pituitary surgery will be reviewed. Since the first surgical approach to pituitary tumors more than 100 years have elapsed. Surgical techniques have been developed, refined and standardized. Selective adenomectomy leads to remission of hormonal oversecretion in many patients and also to recovery of pituitary function. The resection of pseudocapsule around the adenoma seems to improve the operative results further. With the use of the Doppler probe vascular arterial lesions are easily avoided. The application and usefulness of several technical developments will be reviewed, such as the use of the endoscope, magnetic resonance imaging and neuronavigation. The value of intraoperative hormonal measurements will be briefly discussed. Another major advance is the reduction of complications.