Apple Vision Pro-Enabled Endoscopic Endonasal Approach for Pituitary Adenoma Resection: First In-Human Spatial Computing Skull Base Neurosurgery Case Report

Objective: To report first in-human skull base neurosurgery case using Apple Vision Pro Main Outcome Measures: Endoscopic stream with the Apple Vision Pro in an endoscopic endonasal transsellar and left trans cavernous approach for resection of a pituitary adenoma. Results: Endoscopic endonasal approach was performed using the Apple Vision Pro for resection of a pituitary adenoma. The procedure was completed without complication. A postoperative magnetic resonance imaging showed no convincing residual pituitary mass. The patient was discharged on postoperative day 2. Conclusion: Endoscopic streaming to the Apple Vision Pro is safe in skull base surgery. We described the first case report of an Apple Vision Pro-specific spatial computing technology successfully used to display endoscopic feed to the skull base neurosurgeon during skull base neurosurgery with no intraoperative complications. Continued integration of intraoperative navigation platforms, patient vitals, pre-operative imaging, and electronic medical records with endoscopic streams serves as an important step in optimizing surgeon experience and developing a virtual operating room.