CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery
DOI: 10.1055/s-0040-1719123
Technical Note | Nota Técnica

Endonasal Endoscopic Pituitary Adenoma Resection in light of the COVID-19 Pandemic: A Technical Report

Cirurgia endoscópica endonasal para ressecção de macroadenoma hipofisário à luz da pandemia por COVID 19: Nota técnica
1  Neurosurgery Service, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
,
Dan Zimelewicz Oberman
1  Neurosurgery Service, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
,
Alick Durão Moreira
1  Neurosurgery Service, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
,
Luisa Borges
1  Neurosurgery Service, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
,
Felipe Gonçalves
1  Neurosurgery Service, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
,
Gustavo Sereno Porto Cabral
1  Neurosurgery Service, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
,
Rafael Rego Barros
1  Neurosurgery Service, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
,
Rafael Vaitsman
1  Neurosurgery Service, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
,
Rodrigo Sodré
1  Neurosurgery Service, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
,
João Kleskoski
1  Neurosurgery Service, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
,
Orlando Maia
2  Departament of Endovascular Neurosurgery, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
,
Jorge Luis Amorim Correa
1  Neurosurgery Service, Hospital de Força Aérea do Galeão (HFAG), Galeão, Rio de Janeiro, RJ, Brazil
› Author Affiliations

Abstract

Introduction The endoscopic endonasal transsphenoidal approach (EETA) is routinely used to treat sellar and suprasellar tumors. It provides safe and direct access to tumors in these locations, with wide visualization of anatomical landmarks and great surgical results. With the COVID-19 pandemic, despite the high risk of transmission involved, various surgical procedures cannot be postponed due to their emergency.

Case Report A 62-year-old female presented in the previous two months with headaches, followed by bilateral severe visual loss. In 2016, she was submitted to subtotal resection of a non-secretory macroadenoma. Because of the progressive visual deficits, the EETA was used to the resect the pituitary adenoma.

Technical Note We developed a low-cost adaptation to the surgical fields, covering the patient's head and superior trunk with a regular surgical microscope bag with a tiny slit to enable the endoscope and surgical instruments to enter the nose, thus protecting the personnel in the operating room from the aerosolization of particles. This makes surgery safer for the surgical team and for the patient.

Conclusion In view of the lack of literature on this subject, except for some reports of experiences from some services around the world, we describe the way we have adjusted the EETA in the context of the COVID-19 pandemic.

Ethics Committee for Research Protocols

The protocol was approved by the local institutional Review Board (Ethics Committee for Research Protocols – CEPI).




Publication History

Received: 18 June 2020

Accepted: 15 September 2020

Publication Date:
26 November 2020 (online)

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