Advancement of Surgical Visualization Methods: A Comparison Study between Traditional Microscopic Surgery, the Endoscope and a Novel Robotic OptoelectronicVisualization Tool for them Transnasal Transsphenoidal Approach to the Sellar Region

With the entrance of the video microscope over the recent few years into the microsurgery optical field, a third modality has emerged alongside the endoscope and operating microscope to accomplish some of the microsurgical procedures. One such approach that could potentially utilize any of the three is the transnasal transsphenoidal (TNTS) approach that provides access to the anterior brainstem, the anterior skull base, and of course the sellar region. Here, we provide a descriptive comparison of the three modalities on cadaveric specimens with joint ENT and neurosurgery teams performing the approach. Each provides unique advantages and disadvantages as part of the surgeon’s optical armamentarium. As more optical devices become available to surgeons, selection of the optimal device can present a challenge best compared by head-to-head comparison. The aim of this paper is to compare these modalities for the TNTS approach.