title: Endoscopic endonasal transsphenoidal surgery: implementation of an operative and perioperative checklist.
abstract: Endoscopic endonasal surgery relies heavily on specialized operative instrumentation and optimization of endocrinological and other critical adjunctive intraoperative factors. Several studies and worldwide initiatives have previously established that intraoperative and perioperative surgical checklists can minimize the incidence of and prevent adverse events. The aim of this article was to outline some of the most common considerations in the perioperative and intraoperative preparation for endoscopic endonasal transsphenoidal surgery. The authors implemented and prospectively evaluated a customized checklist at their institution in 25 endoscopic endonasal operations for a variety of sellar and skull base pathological entities. Although no major errors were detected, near misses pertaining primarily to missing components of surgical equipment or instruments were identified in 9 cases (36%). The considerations in the checklist provided in this article can serve as a basic template for further customization by centers performing endoscopic endonasal surgery, where their application may reduce the incidence of adverse or preventable errors associated with surgical treatment of sellar and skull base lesions.
authors.affiliation: Department of Neurosurgery, Head and Neck Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California.
authors.forename: Eisha
authors.initials: E
authors.lastname: Christian
authors.forename: Brianna
authors.initials: B
authors.lastname: Harris
authors.forename: Bozena
authors.initials: B
authors.lastname: Wrobel
authors.forename: Gabriel
authors.initials: G
authors.lastname: Zada
mesh_terms: D057189:Checklist; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D059906:Neuroimaging; D019635:Neurosurgical Procedures; D009666:Nose / Q000601:surgery*; D059035:Perioperative Period; D019291:Skull Base / Q000601:surgery*
keywords: ACTH = adrenocorticotropic hormone; BMP = basic metabolic panel; CBC = complete blood count; CD = Cushing’s disease; DDAVP = desmopressin; DI = diabetes insipidus; FSH = follicle-stimulating hormone; GH = growth hormone; IGF-I = insulin-like growth factor-I; LH = luteinizing hormone; PRL = prolactin; PT = prothrombin time; PTT = partial thromboplastin time; T4 = thyroxine; TSH = thyroid-stimulating hormone; checklist; endoscopic endonasal transsphenoidal surgery; endoscopy; pituitary neoplasms; skull base