title: The learning curve in endoscopic pituitary surgery and our experience.
abstract: Experience is the important point in reduction of the complications and in the effectiveness of the surgical procedure in pituitary surgery. Endoscopic pituitary surgery differs from microscopic surgery, since it requires a steep learning curve for endoscopic skills. In this article, we evaluate our learning curve in two groups, as early and late experience. Purely endoscopic transsphenoidal operations were performed on 78 patients, which were retrospectively reviewed and grouped as early and late experience groups. We used the purely endoscopic endonasal approach to the sella that was performed via an anterior sphenoidotomy, without the use of a transsphenoidal retractor. All patients with adenomas were evaluated considering operation time, endocrinology, ophthalmology, total removal and, especially, modifications of standard technique. On the basis of the experience gained with the use of the endoscope in transphenoidal surgery over the years, modifications can be performed on the different phases of the endoscopic approach. Reviewing our cases in two groups of period due to our experience showed that the effectiveness of endoscopic surgery increases and operation time decreases. In our study, we identified a learning curve in endoscopic pituitary surgery.
authors.affiliation: Department of Neurosurgery, Kocaeli University, School of Medicine, 41900 Izmit, Kocaeli, Turkey. kenankoc01@yahoo.com
authors.forename: Kenan
authors.initials: K
authors.lastname: Koc
authors.forename: Koc
authors.initials: K
authors.lastname: Kenan
authors.forename: Ihsan
authors.initials: I
authors.lastname: Anik
authors.forename: Anik
authors.initials: A
authors.lastname: Ihsan
authors.forename: Dilek
authors.initials: D
authors.lastname: Ozdamar
authors.forename: Ozdamar
authors.initials: O
authors.lastname: Dilek
authors.forename: Burak
authors.initials: B
authors.lastname: Cabuk
authors.forename: Cabuk
authors.initials: C
authors.lastname: Burak
authors.forename: Gurkan
authors.initials: G
authors.lastname: Keskin
authors.forename: Keskin
authors.initials: K
authors.lastname: Gurkan
authors.forename: Savas
authors.initials: S
authors.lastname: Ceylan
authors.forename: Ceylan
authors.initials: C
authors.lastname: Savas
mesh_terms: D000236:Adenoma / Q000150:complications / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002983:Clinical Competence; D004703:Endocrine System / Q000502:physiology; D004724:Endoscopy; D005260:Female; D015718:Fibrin Tissue Adhesive; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010902:Pituitary Gland / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000150:complications / Q000601:surgery; D011182:Postoperative Care; D011859:Radiography; D012658:Sella Turcica / Q000601:surgery; D013238:Stereotaxic Techniques; D014014:Tissue Adhesives
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives