Use of Artemis Neuro Evacuation Device in Resection of Pituitary Adenoma: Initial Technical Note.

Abstract

Endoscopic transsphenoidal resection has become the primary approach for resection of pituitary macroadenomas. However, challenges such as narrow sinuses, dense tumor consistency, and invasion of surrounding structures exist. We report a case in which the Artemis Neuro Evacuation device was used to endonasally remove a pituitary macroadenoma with suprasellar and parasellar extensions. The methodology and technical aspects of this device's novel use are illustrated. The long and narrow wand of the Artemis system allowed the operators to navigate through patient's narrow sinuses. Despite a dense tumor that did not come easily into a suction, the entire tumor debulking procedure lasted <10 minutes with the preservation of an intact arachnoid membrane using the Artemis. No perioperative complication was encountered, and the patient's neurologic deficits resolved. To the authors' knowledge, this represents the first reported case of the Artemis system's utility in the treatment of pituitary tumor beyond cranial hematoma and hemorrhage.