Endoscopic endonasal transsphenoidal surgery is performed through the natural nasal air passage. The advantage of this operation is that it is minimally invasive and is performed without skull trepanation. It is important to mention that in the territory of Armenia only the medical center “Nairi” is equipped with the StealthStation navigation system, the use of which during the operation makes it possible to accurately determine pituitary tumor localization, its boundaries and the degree of removal, which minimizes the probability of traumatizing adjacent tissues. In addition, our department is equipped with an ultrasonic selective aspirator "INTEGRA", which recognizes and removes only brain tumor, without injuring healthy tissues. We also want to mention the following advantage of this surgery: usually the tumor is localized in a small area (about 3 cm) and is adjacent to the carotid arteries, venous plexus, optic nerves. Therefore, it is very important to intervene carefully as to minimize the likelihood damages of these important centers. During the surgery, the tumor is maximally removed, but in cases where its lateral borders are closely adjacent to tissues or blood vessels, partial resection of the tumor is carried out for safety. After the operation, a fat tissue is inserted into the cavity of the removed tumor.  Below are preoperative and postoperative images which clearly demonstrate the radical removal of the sellar region tumor.

   a.                                                                               b.

a. preoperative MRI image:  pituitary tumor (shown with the arrows) 

b. Postoperative MRI image: the tumor is practically removed and instead of it the cavity is filled with a hemostatic sponge and fat tissue (shown with the arrows) 

Hospitalization lasts 4-5 days. The patients are allowed to walk the next day. In the postoperative period, depending on the histological structure of the tumor, hormonal or radiation therapy is indicated to individual patients.