目的　将“内镜下经鼻腔 蝶窦入路垂体腺瘤切除术”这一微创手术加以介绍并就相关问题进行探讨。方法　采用直径 4mm的 0°、 30°硬性鼻内镜及配套摄像系统、内镜冲水系统、鼻窦钳等设备 ,内镜下切除垂体腺瘤 30例 ,其中泌乳素腺瘤 12例 ,生长激素腺瘤 2例 ,无功能腺瘤 16例 ,微腺瘤 1例 ,复发垂体腺瘤 1例。结果　内镜下全切肿瘤 2 7例 ,近全切肿瘤 3例 ,术后 2例一过性脑脊液鼻漏 ,1例丘脑出血。术后 13例内分泌化验恢复正常。术后 3～ 8个月随访 14例 ,1例复发 ,无鼻中隔穿孔、萎缩性鼻炎等并发症。结论　内镜下经鼻腔 蝶窦入路垂体腺瘤切除术深部照明好 ,切除肿瘤彻底 ,鼻腔结构损伤小。随着设备的进一步完善和经验的不断提高 ,该术式将会越来越多地得以应用并取得良好效果 Objective To introduce the minimally invasive surgery of endoscopic transnasal transsphenoidal approach pituitary adenoma and discuss related issues. Methods 4mm diameter 0°, 30° rigid nasal endoscopes and supporting camera systems, endoscope flushing system, sinus forceps and other equipment were used. 30 cases of pituitary adenomas underwent endoscopic removal, including 12 cases of prolactin adenoma, growth hormone There were 2 cases of adenomas, 16 cases of nonfunctioning adenomas, 1 case of microadenomas, and 1 case of recurrent pituitary adenomas. [Results] Twenty-seven patients underwent total endoscopic tumor resection, 3 patients had near total tumor resection, 2 patients had transient nasal leakage of cerebrospinal fluid, and 1 patient had thalamic hemorrhage. 13 cases of endocrine tests returned to normal after surgery. Postoperative 3 to 8 months follow-up of 14 patients, 1 case of recurrence, no complications such as nasal septum perforation, atrophic rhinitis. Conclusion Endoscopic transnasal transsphenoidal approach pituitary adenoma resection deep lighting, complete resection of the tumor, nasal cavity structure damage. With the further improvement of equipment and the continuous improvement of experience, this technique will be applied more and more and achieve good results.