“Your body hears everything your mind says.” – Naomi Judd

PNA Spotlight: Dr. Bernard R. Bendok

This month the PNA Spotlight focuses on Bernard R. Bendok, M.D., the William J. and Charles H. Mayo Professor and Chair of Neurological Surgery at Mayo Clinic in Arizona. He was kind enough to answer a few questions from the PNA. Here are his answers, lightly edited for clarity.

Please tell us about your early life, and why you chose pituitary medicine.

I was born in Detroit, and at age five, we moved to Harper Woods, so I spent my childhood living along Lake St. Clair. From age nine to fifteen I lived in Lebanon because my parents moved us there for family and work reasons. In ninth grade during the biology lecture on pituitary disease, in that moment, I decided to be a doctor. My passion for pituitary disease really stems back to this day. I remember distinctly: I was so amazed that this little gland could be a symphony conductor of the body. I didn’t know anything about being a doctor. We have no physicians in the family. Nobody had talked to me about being a doctor. But I knew, at that moment, that I was going to be a doctor. I didn’t know I was going to be a neurosurgeon, but I knew I was going to be a doctor.

Please tell us about your medical training and your mentors.

I went to medical school and did my residency training at Northwestern. I did my fellowship at SUNY Buffalo. While in medical school I learned from a pioneer in pituitary diseases named Dr. Ivan Ciric. He was a towering figure, an amazing surgeon, and an incredible human being. I had the privilege of writing the review of his autobiography, called “Listen to the patient.”  It’s a phenomenal book about health care and the passion and joy of being a doctor, and so I was inspired by him.

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PNA Medical Corner: Endoscopic Endonasal Transsphenoidal Surgery

This month the PNA Medical Corner showcases a study co-authored by several PNA-affiliated specialists: Drs. Joao Paulo Almeida, Juan Carlos Fernandez Miranda, and Daniel Prevedello. The study proposes an intraoperative framework to confirm safe phase progression in endonasal transsphenoidal surgery.

Pituitary  2026 Jan 28;29(1):35.

doi: 10.1007/s11102-026-01636-2.

Critical views for safe surgical phase progression in endoscopic endonasal transsphenoidal pituitary adenoma resection: modified Delphi consensus

Tjasa Zaletel ^# 1 2, Danyal Z Khan ^# 3 4, Anjana Wijekoon ^5 6, Zhehua Mao ^5 6, Joao Paulo Almeida ⁷, Anouk Borg ², Jonathan Chainey ⁸, Michael D Cusimano ⁹, Daniel A Donoho ^10 11, Neil Dorward ², Juan Carlos Fernandez-Miranda ¹², Giorgio Fiore ¹³, Theofanis Giannis ², Alfonso Lagares Gomez-Abascal ^14 15 16, Lauren Harris ², Abhiney Jain ^2 5, Ruth Lau ¹⁷, Sacit B Omay ¹⁸, Igor Paredes ^14 15 16, Daniel Prevedello ¹⁹, Gabriel Zada ²⁰, 

Danail Stoyanov ^5 6, Sophia Bano ^5 6, Hani J Marcus ^2 5

Affiliations Expand

• PMID: 41604016   PMCID: PMC12852166   DOI: 10.1007/s11102-026-01636-2

Abstract

Purpose: Endonasal transsphenoidal surgery is the gold-standard for pituitary adenoma resection, yet no intraoperative framework exists to confirm safe phase progression. Inspired by the Critical View of Safety in laparoscopic cholecystectomy and engineering “phase-gate” process, we propose the Critical Views for Phase Progression (CVPPs) – a set of visual cues confirming phase objectives and safe phase progression. Designed to be clinically relevant and machine-readable, CVPPs aim to support training and future AI-driven guidance systems.

Methods: A three-round modifi

ed Delphi process was conducted involving 15 pituitary surgery experts from 13 centres across Europe and North America. CVPPs for the naso-sphenoid, sellar, and closure phases were classified as “Essential”, “Desirable” or “Not Necessary”. Consensus required ≥ 70% agreement. A local validation study was subsequently performed involving six experts who reviewed 15 intraoperative video clips and rated their confidence to proceed, which was compared against the predefined reference derived from the finalised CVPPs.

Results: Consensus identified essential and desirable CVPPs across all three phases for both micro- and macroadenoma variants, reflecting differences in exposure goals and surgical risk. Validation demonstrated high concordance between participant ratings and predefined references. Discrepancies arose only in a minority of intentionally incomplete (“unsafe”) views and were attributable to contextual misinterpretation of short video segments, rather than disagreement with the CVPP framework.

Conclusion: This international, multicentre consensus is the first to define CVPPs. By standardising intraoperative visual benchmarks, CVPPs can enhance training, mitigate risks, and provide a foundation for future AI-driven guidance systems capable of real-time anatomical annotation and decision support.

Keywords: CVPP; Consensus; Delphi; Endoscopic endonasal; Endoscopic transsphenoidal surgery; Pituitary adenoma.

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Conflict of interest statement

Declarations. Ethical approval: Ethical approval and informed consent were unnecessary due to the nature of the study (consensus process amongst health care professionals). Participation in this study was voluntary. Competing interests: HJM is an employee of and has shares in Panda Surgical. DS is an employee of Digital Surgery, Medtronic and has shares in Panda Surgical, Odin Vision, EnAcuity and Helico Medical. JPA is a consultant for Stryker. MDC serves on the Pfizer Medical Advisory Board.

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