The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on endoscopic transsphenoidal pituitary adenoma resection.


The pituitary gland is a small structure attached to the base of the brain behind the nose, where it is protected by a part of the skull called the sphenoid bone.

Pituitary adenomas are benign slow-growing tumours that arise within the pituitary gland. Most pituitary adenomas are microadenomas, or small tumours, although a few patients have macroadenomas, which are larger.

The treatment options for pituitary adenomas include surgery, drugs and radiotherapy.

Endoscopic transsphenoidal pituitary adenoma resection is carried out under general anaesthetic.  An endoscope is inserted into the nostril towards the base of the tumour at the skull base.

Surgical instruments are then inserted next to the endoscope through the same nostril. The tumour is removed and the bony floor of the space occupied by the pituitary is closed.

Patients usually undergo the procedure via the right nostril, however surgery is sometimes done via the left nostril, depending on the location of the tumour.

Coding recommendations

B04.1 Excision of lesion of pituitary gland

Y76.6 Endonasal endoscopic approach to other body cavity