Editor's note:

In response to the Belt and Road Initiative, and with the aim of sharing expertise and addressing shared health challenges, our hospital has launched the Overseas Promotion Program for New Medical Technologies. If you are interested in any of the medical technologies covered under this program, please feel free to contact the International Cooperation Office at faowch@163.com.

Pituitary adenoma is among the most frequently encountered pathologies in neurosurgery. Endoscopic endonasal surgery (EES), now the mainstream treatment modality, has been increasingly adopted worldwide, with a steadily rising annual surgical volume. Conventional EES, however, typically requires an assistant to hold the endoscope, limiting surgical freedom and increasing dependence on team coordination. To overcome this constraint, the neurosurgical team at West China Hospital, Sichuan University, developed the “T-holding chopsticks technique” in 2020, following years of clinical innovation.

The T-holding chopsticks technique is a novel method of endoscope stabilization that applies the mechanical principles of traditional chopstick manipulation. It enables the primary surgeon to simultaneously and stably control both the endoscope and a suction device with one hand, allowing the contralateral hand to perform delicate bimanual maneuvers within the narrow nasal cavity throughout the procedure.

The core advantages of this technique include:

• Reduced Surgical Personnel Requirements and Simplified Workflow: The surgeon can operate independently without an assistant or robotic endoscope holder, enabling a solo surgical model of “one surgeon, single nostril, two hands, three instruments.” This is particularly advantageous in centers with limited surgical staff or inconsistent operative partnerships.
• Minimally Invasive and Enhanced Precision: The majority of procedures can be completed via a single-nostril approach, significantly reducing nasal trauma and preserving physiological functions such as olfaction. The stable, surgeon-controlled endoscopic field markedly improves the efficiency and precision of critical maneuvers, including tumor resection, hemostasis, dissection, and suturing.
• Broad Applicability and Ease of Adoption: The technique does not require specialized or costly equipment and can be mastered through structured training, making it readily adoptable across institutions with varying levels of resources.

Since 2020, the T-holding technique has been successfully employed in over 1,000 EES cases at West China Hospital, encompassing a range of skull base lesions including pituitary adenomas, craniopharyngiomas, and chordomas, with excellent clinical outcomes. To disseminate this innovation, we have conducted two national advanced training workshops and live-streamed 17 complex surgical cases to a nationwide audience. All patients experienced uneventful postoperative recovery, earning widespread acclaim and professional recognition.