Endoscopic Transsphenoidal Approach Instruments [Neurosurgery Wiki]

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====== Endoscopic Transsphenoidal Approach Instruments ======

The application of various angled [[endoscope]]s allows a look "around the corner" resulting in a potentially higher radicality of tumour resection in [[endonasal]] [[transsphenoidal]] surgery
((Oertel J, Gaab MR, Linsler S. The endoscopic endonasal transsphenoidal
approach to sellar lesions allows a high radicality: The benefit of angled
optics. Clin Neurol Neurosurg. 2016 Jul;146:29-34. doi:
10.1016/j.clineuro.2016.04.016. Epub 2016 Apr 22. PubMed PMID: 27136095.
)).

Barycenter of the instrument is the surgeon's hands. Many different tips with different functions. Elimination of the bayonet-like shape. Handle bent in the horizontal plane to avoid interference with the surgeon's hands and to allow the distal, thin part of the instrument to be used safely and comfortably
((Cappabianca P, Alfieri A, Thermes S, Buonamassa S, de Divitiis E. Instruments 
for endoscopic endonasal transsphenoidal surgery. Neurosurgery. 1999
Aug;45(2):392-5; discussion 395-6. PubMed PMID: 10449087.
)).

http://www.mizuho.com/product/kelly-endonasal-endoscopic-set/


[[Antrum punch]]es  – backward cutting, 360 degree rotatable, pediatric version available
    
[[Nasal forcep]]s – through cutting, straight and 45 degree angled up
    
Nasal scissors  – straight, curved left and right to navigate nasal aperature
    
Suctions – Tapered 1 piece, tear drop suction for greater manipulation
    
Rongeurs – 2mm, 3mm, 4mm various angles
    
Bipolar forceps – 0.7mm and 1.0mm tips, straight and angled tips
    
Dissectors – single shafted bayoneted ring curettes, pistol grip scissors, cup forceps

Cottle elevator, probes, spatulas, and more