A Learning Curve of Endoscopic Transsphenoidal Surgery for Pituitary Adenoma

Chi, Feng-ling; Wang, Yu; Lin, Yuan-Hsiang; Ge, Jian; Qiu, Yongming; Guo, Liemei

doi:10.1097/scs.0b013e3182a24328

Cited by 50 publications

(55 citation statements)

References 21 publications

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“…Previously published data on EEA learning curves by Fengling et al 8 and Smith et al 6 showed improvements in operative time, DI and mean LOS. Fengling divided their study of 80 patients into two groups while Smith et al divided their cohort of 51 patients into three groups.…”

Section: Discussionmentioning

confidence: 95%

“…The most recent study in 2013 showed increase in the requirement of cases required for the learning curve to 40 cases. 8 The Fengling study, however, separated the early and late groups equally. Our study separated the groups based on the transition of significant improvement in outcomes and complications.…”

Section: Learning Curvementioning

confidence: 97%

“…6,7 A more recent study in 2013 estimated an experience of approximately 40 cases in EEA for a significant lowering in operating room (OR) time, post-op hospital stay, and effectiveness of the endoscopic approach. 8 The present study will describe the learning curve in a consecutive series of patients undergoing EEA for pituitary adenoma resections.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Learning curve for the transsphenoidal endoscopic endonasal approach to pituitary tumors

Qureshi

Chaus

Fogg

et al. 2016

British Journal of Neurosurgery

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Section: Discussionmentioning

confidence: 95%

Section: Learning Curvementioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Learning curve for the transsphenoidal endoscopic endonasal approach to pituitary tumors

Qureshi

Chaus

Fogg

et al. 2016

British Journal of Neurosurgery

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“…Surgeon experience is positively associated with postoperative VF deficit improvement . Whether the adenoma is secreting or nonsecreting does not predict visual outcome after surgery .…”

Section: Intradural Tumorsmentioning

confidence: 97%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

139

270

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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“…Various factors result in a steep learning curve for performing endoscopic procedures. 16 The 3D-printed simulators allow neurosurgeons to strengthen basic surgical skills and become familiar with complex neurosurgical procedures.…”

Section: Endoscope and Exoscopementioning

confidence: 99%

A Practical 3D-Printed Model for Training of Endoscopic and Exoscopic Intracerebral Hematoma Surgery with a Tubular Retractor

Zhu

Wen

Tang

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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Objective To present a three-dimensional (3D)-printed model that simulates endoscopic and exoscopic intracerebral hematoma (ICH) surgery with a tubular retractor. Methods We used 3D printing technology to develop the model that consisted of the skull frame and a replaceable inserted module. Edible gelatin and animal blood were placed into the module to mimic brain tissue and the hematoma. Twenty neurosurgeons were recruited to participate in our training program that required the use of an endoscope and an exoscope to aspirate the hematoma with a tubular retractor. Five postgraduates were asked to complete the entire training with the endoscope five times. Questionnaires were distributed for feedback after the training program. Results The more experienced surgeons obviously performed better than the rather inexperienced surgeons, verifying that our model could reflect the ability of the trainees. As the training progressed, the scores of the postgraduates increased, and the average score of the fifth training was obviously higher than the first score. No significant differences were observed in the trainees' performance with the endoscope and the exoscope. The feedback questionnaires showed the average score for value of the simulator as a training tool was a 3.65 (on a 4-point scale). Our model received better comments regarding the bone texture (mean: 3.20), the brain tissue texture (mean: 3.20), and the experience in aspirating the hematoma (mean: 3.10). The surgical position (mean: 2.95), surgical approach (mean: 2.90), and simulated brain tissue (mean: 2.85) should be improved. Conclusion Our model was practical for endoscopic and exoscopic ICH surgery training. The results of our program showed that prior surgical experience benefited the mastery of both the endoscopic and the exoscopic ICH surgery in the 3D-printed model. Our model could make mastering basic skills more efficient.

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A Learning Curve of Endoscopic Transsphenoidal Surgery for Pituitary Adenoma

Cited by 50 publications

References 21 publications

Learning curve for the transsphenoidal endoscopic endonasal approach to pituitary tumors

Learning curve for the transsphenoidal endoscopic endonasal approach to pituitary tumors

ICAR: endoscopic skull‐base surgery

A Practical 3D-Printed Model for Training of Endoscopic and Exoscopic Intracerebral Hematoma Surgery with a Tubular Retractor

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