Use of Artemis Neuro Evacuation Device in Resection of Pituitary Adenoma: Initial Technical Note

Background: Endoscopic transsphenoidal resection has become the primary approach for resection of pituitary macroadenomas. However, challenges such as narrow sinuses, dense tumor consistency, and invasion of surrounding structures exist. Methods: We report a case in which the Artemis Neuro Evacuation device was used to endonasally remove a pituitary macroadenoma with suprasellar and parasellar extensions. The methodology and technical aspects of this device's novel use are illustrated. Results: The long and narrow wand of the Artemis system allowed the operators to navigate through patient's narrow sinuses. Despite a dense tumor that did not come easily into a suction, the entire tumor debulking procedure lasted <10 minutes with the preservation of an intact arachnoid membrane using the Artemis. No perioperative complication was encountered, and the patient's neurologic deficits resolved. Conclusions: To the authors’ knowledge, this represents the first reported case of the Artemis system's utility in the treatment of pituitary tumor beyond cranial hematoma and hemorrhage.