The U-shaped incision and diagonal suturing of the sellar dura in endoscopic transsphenoidal pituitary adenoma resection.

Abstract

Endoscopic endonasal transsphenoidal (EET) approach has been widely utilized for the treatment of pituitary adenoma. However, postoperative cerebrospinal fluid (CSF) leakage is still a concern. One of the key surgical points to prevent postoperative CSF leakage is how to reduce the defect of the sellar floor and increase its support. We presented a step-by-step description of the incision method of the sellar dura during endoscopic transsphenoidal pituitary adenoma resection, as well as the sellar dura mater diagonal suture technique to reduce postoperative sellar dura mater defects and increase the support of the sellar floor. These methods have been widely applied in our surgical procedures. These measures effectively increase the support of the sellar floor and reduce the risk of postoperative CSF leakage in cases of low cerebrospinal fluid leakage during surgery, and are easy to perform.