Study objective: To learn how to avoid injury to the carotid artery during recurrent pituitary surgery.

Design: Through transsphenoidal endonasal approach the steps of surgery with avoidance of complications were described in the video particularly the use of Minidoppler was to localise the carotids.

Setting: Comfort Nursing Home, a private hospital in Dhaka, Bangladesh.

Subject/Audience: Neurosurgeons/Residents.

Intervention: Demonstration of transsphenoidal endonasal approach for recurrent pituitary tumor and use of Minidoppler to avoid carotid artery injury.

Results: Avoidance of complications like intraoperative accidental injury to carotids where symptomatic tumor is small and inter carotid distance is less. Taking this into account, we created this video to demonstrate the important steps specifically to use Minidoppler to avoid a devastation like carotid artery injury.

Conclusion: The steps of recurrent pituitary surgery through endonasal approach is well established. To evaluate the details of anatomical structures specifically the inter carotid distance prior to surgery will prevent the unwanted complications in recurrent pituitary surgery and with high resolution monitoring and use of Minidoppler, carotid arteries can be localised.