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. 2026 Jul 13;13:1851438. doi: 10.3389/fsurg.2026.1851438

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© 2026 Xin, Xiang, Liu, Guo, Bai, Zhu, Geng, Xie, Cong and Ma.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Panel A shows a sagittal MRI brain scan with a mass in the suprasellar region. Panel B shows a coronal MRI indicating the same lesion. Panels C to H depict sequential intraoperative endoscopic views of a transsphenoidal surgical procedure for tumor removal, illustrating dissection, tumor extraction, and the exposed surgical cavity. — A typical case of grade 3 intraoperative leakage. Male, 54 years old, admitted for decreased vision in both eyes. (A,B) Preoperative MR demonstrates a pituitary tumor with suprasellar extension and inferior invasion into the sphenoid sinus. (C) A massive defect in the diaphragma sellae reveals clearly visible vessels within the suprasellar cistern. (D,E) Cover the entire sellar region with artificial dura mater. (F,G) Fill the tumor cavity with gelation sponge to ensure tightly adhesion between artificial dura mater and sellar diaphragma. (H) Sealing with porcine fibrin sealant.