Surgical Videos by
Dr. JFM
Watch real surgical procedures performed by Dr. Fernandez-Miranda at Stanford. These videos demonstrate minimally invasive endoscopic endonasal and advanced open skull base techniques for pituitary tumors, craniopharyngiomas, chordomas, meningiomas, and other complex skull base and brain lesions.
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These surgical videos contain real operative footage intended for patient education and healthcare professionals. Viewer discretion is advised. Some videos may require YouTube sign-in due to content restrictions.
Dr. Fernandez-Miranda has performed over 2,000 endoscopic endonasal operations for pituitary tumors and other skull base lesions. The endoscopic endonasal approach is a minimally invasive technique that accesses the pituitary gland through the nose, avoiding any external incisions. Below are examples demonstrating this approach for different types of pituitary tumors.
Endoscopic Endonasal Approach for Pituitary Tumor Removal
Dr. Fernandez-Miranda narrates this simulation demonstrating the step-by-step endoscopic endonasal approach to pituitary tumor removal and his pioneering technique for medial wall resection of the cavernous sinus
Demonstration of Dr. Fernandez-Miranda's pioneering technique for medial wall resection of the cavernous sinus — the innovation behind the cure of Cushing's disease in this young patient after previous failed surgeries.
This prolactinoma patient was first treated with cabergoline but developed side effects with worsening depression symptoms. Recent innovations introduced by Dr. Fernandez-Miranda allowed for complete tumor resection, with much improved quality of life and normal prolactin levels now 5 years after surgery.
​Acromegaly is caused by a growth hormone-secreting pituitary tumor that invades the cavernous sinus in many cases. Traditional surgical approaches have reported remission rates of only 50-60%. Dr. Fernandez-Miranda pioneered the technique of medial wall resection of the cavernous sinus, achieving biochemical remission in most patients — including those who had unsuccessful surgery elsewhere. This represents the highest reported remission rate in the field.
Demonstration of Dr. Fernandez-Miranda's pioneering technique for medial wall resection of the cavernous sinus — the innovation behind his record 90%+ biochemical remission rate for acromegaly. Here 3 case examples with different patters of invasion requiring specific surgical techniques as described by Dr. Fernandez-Miranda.
Craniopharyngiomas are among the most challenging brain tumors, arising from the pituitary stalk near the hypothalamus and visual pathways. Dr. Fernandez-Miranda has developed endoscopic endonasal techniques that achieve complete tumor resection — including cases previously considered inoperable — while preserving hypothalamic, cognitive and visual functions. Complete resection is especially important in children, where long-term outcomes depend on minimizing the need for additional treatments.
Endoscopic endonasal removal of a complex craniopharyngioma in a pediatric patient, demonstrating the subpial dissection technique for hypothalamic and pituitary stalk preservation. Tumor was completely removed and patient is tumor-free 5 years after surgery.
Chordoma is a rare bone cancer of the skull base that affects approximately one in a million people. Dr. Fernandez-Miranda is one of very few neurosurgeons worldwide with true expertise and innovation in chordoma surgery. He has pioneered endoscopic endonasal techniques for skull base chordomas, describing novel surgical approaches and anatomical nuances. Complete surgical resection is associated with longer survival and reduced recurrence, making surgeon expertise a critical factor in outcomes.
Endoscopic endonasal approach for resection of a complex clival chordoma, demonstrating the minimally invasive technique for this rare skull base cancer.
Chondrosarcomas are rare cartilaginous tumors that can arise at the skull base. Like chordomas, they require expert surgical management for optimal outcomes. Dr. Fernandez-Miranda uses advanced endoscopic endonasal and open skull base techniques tailored to the specific location and extent of each tumor, with the goal of complete resection while preserving critical neurovascular structures.
Endoscopic endonasal supratotal resection of a skull base chondrosarcoma in a young patient using the transcavernous approach, leveraging advanced anatomical knowledge to achieve complete tumor removal and optimize long-term outcomes.
Skull base meningiomas are the most challenging meningiomas because they arise near critical nerves and blood vessels at the base of the brain. Dr. Fernandez-Miranda selects the most effective and least invasive approach for each patient — including endoscopic endonasal, open skull base, and combined approaches — tailored to the specific tumor location. The videos below demonstrate the range of techniques used.
Complete endoscopic endonasal removal of a large central skull base meningioma — a case most neurosurgeons would approach through open craniotomy. Total resection achieved through a minimally invasive corridor, navigating critical nerves and vessels.
Posterior clinoid meningioma removed via open middle fossa transcavernous approach — where a subtle shift in tumor location favors an open over endonasal corridor. Features Dr. Fernandez-Miranda's self-designed extensible microdissectors, adaptable to both approaches, reflecting his ability to select the optimal strategy for each patient.
Two cases of optic nerve meningiomas removed via endoscopic endonasal approach — the ideal corridor when tumor extends from the central skull base into the optic canal laterally, allowing direct visualization and precise dissection to preserve and restore vision.
Dr. Fernandez-Miranda treats the full spectrum of skull base and brain tumors beyond the conditions featured above. Additional surgical videos will be added here as they become available.