Pioneering Research by PGIMER Neurosurgeons “In a first of its kind, endoscopic skull base surgeons led by Dr. Dhandapani SS,and Dr.Ninad from Deptt.of Neurosurgery, PGIMER have shown how the use of advanced neurosurgical gadgets can improve the outcome of endoscopic surgery for pituitary tumours. The results are published in “Neurosurgical Review,” one of the premierjournals. The pituitary is the ‘master gland’ of our body,controlling several hormone glands such as thyroid, adrenal, and sex organs.Pituitary tumours are the most challenging of neuroendocrinological issuesfaced by neurosurgical patients. Being close to the nerves carrying vision fromthe eyes to the brain, these often decrease vision and sometimes blindness.They can either secrete too much or result in too little hormones. As a result,there can be problems ranging from obesity, diabetes mellitus, sexualdysfunction, tiredness, and sometimes coma. Sometime back, microscopic surgery through the nosewas the standard. Over the last one or two decades, endoscopic surgery hasbecome increasingly popular. Endoscopy through the nose had several advantages,such as fewer complaints of nose and sinuses.
Some of the large pituitary tumors were still difficult to operate. Recently neuronavigation was introduced forbetter precision during neurosurgery for complex tumors. Surgical navigationis a computerized technology to Vandoeuvre precisely and identify targetssimilar to GPS in mobile devices. Also, angled endoscopes could help surgeonssee the tumor portions in crucial areas, like a periscope. Though these tools are being used widely, there hasnot been adequate proof of their actual efficacy. The study led by Dr.Dhandapani SS is the first to show that navigation and angled endoscopes help agood surgeon deliver even better results. Navigation was helpful during surgeryin almost half of the cases. The tumor resection rates improved from 71% to87%, and the re treatment rates decreased from 21% to 8% with navigation. Incomplex hormone-secreting tumors, the cure rate improved from 0% to 69% usingnavigation. Angled endoscopes were helpful in additional tumor removal in 63%of cases. In non-secreting tumors, angled endoscopes improved resection ratesfrom 71% to 92%, and re treatment rates decreased from 16% to 0%.
Notably, Dr.Dhandapani’s team in PGIMER had also previously pioneered many newdevelopments in minimally invasive endoscopic brain and spine surgery. Thelatest publication on endoscopic endonasal surgery adds a new feather in theircap of laurels.”
