Kings College Hospital Neurosurgical Endoscopic Pituitary and Skull Base Fellowship

Based at: King's College Hospital NHS Foundation Trust

Surgical Specialty Association approving: RCS England

Approval period: Initially approved February 2016; reapproved December 2019–February 2023; reapproved June 2024–May 2027

Supervisor/Lead Consultant: Mr Sinan Barazi, Consultant Neurosurgeon, with Miss Eleni Maratos, Consultant Neurosurgeon

Fellowship duration: 12 months

Stated learning outcomes:

  • Demonstrate a holistic approach to the management of patients with pituitary and skull base pathologies.
  • Effectively work in an MDT setting.
  • Evaluate treatment options and communicate these effectively with the patient, including potential outcomes and complications, and document these discussions accurately.
  • Demonstrate competence in endoscopic and microscopic surgical techniques.
  • Demonstrate experience in critical appraisal of articles submitted to peer-reviewed journals.

Clinical competencies to be achieved:

  • Ability to work within a multidisciplinary setting, and safely and appropriately manage skull base and pituitary pathologies, operatively and non-operatively.
  • Ability to safely resect pituitary functioning/non-functioning lesions using the endoscope as a lead surgeon with appropriate assistance.
  • Ability to effectively deal with intra-operative/post-operative complications, e.g. CSF rhinorrhoea, diabetes insipidus.
  • Ability to safely resect skull base pathologies, e.g. meningiomas, vestibular schwannomas, and other less common lesions, and to deal with their potential complications.

The number of main operations the fellow could expect to be involved in:

Supervisor 2015: “Our previous fellow performed 78 pituitary operations over 12 months, and our current fellow, with 6 weeks left of the Fellowship, has performed 60.  Since 2008, all of our pituitaries have been performed endoscopically, and as this is a two-surgeon operation, my registrar is always involved with the operation at different stages, according to his/her ability.  There is, therefore, no impact on his/her training. Our current fellow has performed 126 skull base procedures to date (with 6 weeks left), and this includes the 60 pituitaries.  Of the remaining 66 cases, these are composed of a mix of skull base lesions, but more frequently meningiomas, vestibular schwannomas, microvascular decompressions, and less commonly craniopharyngiomas (nearly all of which are also performed endoscopically), epidermoids etc.”

Fellows awarded Fellowship Certificate (dates of Fellowship):

  • Konstantinos Barkas (Aug 2015 - Aug 2016)
  • Jonathan Shapey (Aug 2016 - Aug 2017)
  • Eleni Maratos (Aug 2017 - Mar 2018)
  • Michael Hugelshofer (May 2018- Dec 2019)
  • Mohamed Okasha (Mar 2020 - Aug 2021)
  • Alexandros Boukas (Sep 2021 - Sep 2022)
  • Theofanis Giannis (Sep 2022 - Aug 2023)