Our pituitary surgical approach is to use an endoscope, a thin fiber-optic tube with a tiny camera at the tip. This way, the incision under the upper lip or along the nasal septum isn’t needed, because the endoscope allows the surgeon to see through a small incision that’s made in the back of the nasal septum. The surgeon passes instruments through the nose and opens the sphenoid sinus to reach the pituitary gland and take out the tumor. Whether this technique can be used depends on the tumor’s position and the shape of the sphenoid sinus.