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Objective: To discuss the primary experience and possibility of direct transsphenoidal pituitary adenoma resection under endoscopic assistance., Methods: From March 2000 to March 2001, 22 patients with pituitary adenoma were treated by direct transsphenoidal pituitary adenoma surgery under endoscope. During direct transsphenoidal approach, no incision of the nasal mucosa was made without the dissection of the nasal septum and median nasal conchae. Under endoscopic assistance, the anterior wall of the sphnoidal sinus and sellae base was opened directly and adenoma resection was performed., Results: All the patients were followed up for 1 approximately 12 months. The increased hormone level in 17 patients were decreased to normal postoperatively. By postoperative MRI detection, adenomas in 15 patients were removed completely, but part of the adenomas were left in the carvernous sinuses in 7 patients. Temporary diabetes insipidus was observed in 4 patients., Conclusions: The direct transsphenoidal approach in pituitary adenoma resection under endoscopic assistance is time saving, and safe, with good exposure of operative field. The injury to the patient and postoperative reaction are less. The effects were satisfactory without severe complications.