title: Evaluation of the 3-dimensional endoscope in transsphenoidal surgery.
abstract: BACKGROUND
  Three-dimensional (3-D) endoscopy is a recent addition to augment the transsphenoidal surgical approach for anterior skull-base and parasellar lesions. We describe our experience implementing this technology into regular surgical practice.
  
  
  OBJECTIVE
  Retrospective review of clinical factors and outcomes.
  
  
  METHODS
  All patients were analyzed who had endoscopic endonasal parasellar operations since the introduction of the 3-D endoscope to our practice. Over an 18-month period, 160 operations were performed using solely endoscopic techniques. Sixty-five of these were with the Visionsense VSII 3-D endoscope and 95 utilized 2-dimensional (2-D) high-definition (HD) Storz endoscopes. Intraoperative and postoperative findings were analyzed in a retrospective fashion.
  
  
  RESULTS
  Comparing both groups, there was no significant difference in total or surgical operating room times comparing the 2-D HD and 3-D endoscopes (239 minutes vs 229 minutes, P = .47). Within disease-specific comparison, pituitary adenoma resection was significantly shorter utilizing the 3-D endoscope (surgical time 174 minutes vs 147 minutes, P = .03). These findings were independent of resident or fellow experience. There was no significant difference in the rate of complication, reoperation, tumor resection, or intraoperative cerebrospinal fluid leaks. Subjectively, the 3-D endoscope offered increased agility with 3-D techniques such as exposing the sphenoid rostrum, drilling sphenoidal septations, and identifying bony landmarks and suprasellar structures.
  
  
  CONCLUSIONS
  The 3-D endoscope is a useful alternative to the 2-D HD endoscope for transnasal anterior skull-base surgery. Preliminary results suggest it is more efficient surgically and has a shorter learning curve. As 3-D technology and resolution improve, it should serve to be an invaluable tool for neuroendoscopy.
authors: Brain Tumor Center & Pituitary Disorders Program, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California 90404, USA. garni.barkhoudarian@gmail.com
authors: Garni
authors: G
authors: Barkhoudarian
authors: Alicia
authors: A
authors: Del Carmen Becerra Romero
authors: Edward R
authors: ER
authors: Laws
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D012189:Retrospective Studies; D012888:Skull Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013100:Sphenoid Bone / Q000473:pathology / Q000601:surgery*