• Yeong Jin Kim, In-Young Kim, Sue Jee Park, Tae-Young Jung, Kyung-Sub Moon, and Shin Jung.
• Department of Neurosurgery, Chonnam National University Research Institute of Medical Science, Chonnam National University Hwasun Hospital and Medical School, Hwasun-gun, South Korea.
• World Neurosurg. 2024 Oct 9.

BackgroundIn endoscopic transsphenoidal surgery for pituitary adenoma with suprasellar extension, the prolapse of the stretched floppy diaphragma sellae can obstruct the surgical corridor, posing challenges during pituitary surgery. We introduce a simple postural change technique to mitigate this issue and share our clinical experience.MethodsPituitary surgery is performed on an operating table where the patient's position can be adjusted. During transsphenoidal pituitary surgery, raising the patient's head to a Fowler position causes the diaphragma sellae to move upward, whereas lowering the head to a supine position causes it to descend. This simple adjustment minimizes hindrance from the floppy diaphragma sellae during surgery.ResultsWe illustrate this technique in pituitary surgery, where diaphragm sellae relocation is necessary.ConclusionsA simple postural change technique effectively manages prolapsed floppy diaphragma sellae, enhancing visualization and surgical accessibility during endoscopic transsphenoidal pituitary surgery.Copyright © 2024. Published by Elsevier Inc.

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