Transsphenoidal Surgery Procedure

So the surgeon will make an opening in the mucosa, go through any small amount of bone that may be there, make an opening in the membrane that we called the Dura and come face to face with what’s typically a very, very soft tumor. And the tumor actually almost wants to get out of there. And so upon opening it in many, many tumors, the tumor will actually sort of almost gush out a little bit. And typically those tumors, they’re soft, they’re often milky white, sometimes a red tinge because of previous hemorrhage and soft enough that we don’t need to pull them out, but we’ve got these special blunt rings, they’re called ring curettes, and by putting those ring curettes into the area of the pituitary tumor, we can essentially almost scoop it out, like you’d scoop out soft ice cream. And, slowly with time the pulsation of the brain itself will push more and more tumor out into the surgical field. And eventually these ring curettes will recover less and less tumor and finally, no tumor. And that’s when the surgeon knows that, “hey, I’ve gotten out all the tumor I can from this corridor.” and typically stops. And either this is being done through operating room microscope. So a special microscope designed to look down corridors like this and offer good lighting and good magnification or through a scope, which is a technology that originally it was used for other parts of body brought to the neurosurgical field and found a great application in pituitary surgery where a scope is placed. But essentially, a lot of the mechanics of how the tumor is removed is the same, whether it’s through the operating room microscope or a endoscopic approach.