ArticleGland surgery2025
The application of augmented reality technology in endoscopic pituitary adenoma surgery via nasal approach.
Article in Gland surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Apple Vision Pro-Enabled Endoscopic Endonasal Approach for Pituitary Adenoma Resection: First In-Human Spatial Computing Skull Base Neurosurgery Case Report.Journal of neurological surgery reports · 2026Article
- The Role of Virtual and Augmented Reality in Transsphenoidal Surgical Approaches to the Sellar and Parasellar Area-A Systematic Review.Journal of clinical medicine · 2026Review
- Anatomical Features of the Sphenoid Sinus and Their Clinical Significance in Transsphenoidal Accesses to the Pituitary Gland and Parasellar Region: A Systematic Review.Diagnostics (Basel, Switzerland) · 2025Review
- Pediatric nasal dermoid sinus cysts: advances in pathogenesis, management strategies, and translational research-a multidisciplinary management perspective.Frontiers in pediatrics · 2025Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In recent years, neuroendoscopy has mostly replaced the microscope for transnasal pituitary adenoma (PA) surgery, where identifying cranial base anatomical landmarks is crucial. Although neuronavigation systems are commonly used in endoscopic procedures to offer locational data, traditional ones are costly, complex to operate, and need surgical pauses for two-dimensional (2D) imaging to verify positions. This makes them hard for resource-limited primary hospitals to use. Augmented reality (AR) technology, integrating three-dimensional (3D) imaging with the intraoperative endoscopic view, overcomes these drawbacks and could be a key advance in next-generation surgical navigation. This study aimed to develop and evaluate an endoscopy-AR system for localizing PAs and adjacent critical structures, assessing its practicality and accuracy in anatomical models and clinical cases to determine its efficacy in transnasal neuroendoscopic PA surgery. Methods: Using 3D-Slicer software, we performed 3D reconstructions of key anatomical structures, including the sphenoid sinus, PA, internal carotid arteries, and optic nerves. The 3D models were integrated into the endoscopic view via a custom-developed personal computer (PC) software module, "Vrendo". After verifying registration accuracy using five 3D-printed skull models, the technology was applied in seven clinical surgeries for transnasal PA removal, with postoperative complications and outcomes recorded. Results: The AR system provided precise localization of the optic nerves, bilateral internal carotid arteries, and tumor before opening the sellar floor, significantly improving intraoperative orientation. The average target registration error (TRE) was 2.23±0.57 mm in the 3D-printed models. Conclusions: The integration of AR-based 3D imaging with the endoscopic perspective allows for precise localization of deep-seated anatomical structures. This novel approach to intraoperative navigation reduces the need for visual and cognitive transitions between the navigation and endoscope monitors, potentially enhancing surgical safety and efficiency while improving surgeon comfort.
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