Closure of skull base defects after endoscopic endonasal transsphenoidal surgery: the role of the local sphenoid mucosal flap for low flow leaks

2021 ◽  
Author(s):  
Mendel Castle-Kirszbaum ◽  
Yi Yuen Wang ◽  
Brent Uren ◽  
Ben Dixon ◽  
Joanne Rimmer ◽  
...  
Keyword(s):  
Skull Base ◽  
Transsphenoidal Surgery ◽  
Low Flow ◽  
Endoscopic Endonasal ◽  
Mucosal Flap ◽  
Endoscopic Endonasal Transsphenoidal Surgery ◽  
Skull Base Defects

scholarly journals Application of 3D printed model for planning the endoscopic endonasal transsphenoidal surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xing Huang ◽  
Ni Fan ◽  
Hai-jun Wang ◽  
Yan Zhou ◽  
Xudong Li ◽  
...  
Keyword(s):  
3D Printing ◽  
Skull Base ◽  
Transsphenoidal Surgery ◽  
Three Dimensional ◽  
Spatial Relationship ◽  
Cranial Computed Tomography ◽  
Imaging Data ◽  
Endoscopic Endonasal ◽  
Endoscopic Endonasal Transsphenoidal Surgery

AbstractThe application of 3D printing in planning endoscopic endonasal transsphenoidal surgery is illustrated based on the analysis of patients with intracranial skull base diseases who received treatment in our department. Cranial computed tomography/magnetic resonance imaging data are attained preoperatively, and three-dimensional reconstruction is performed using MIMICS (Materialise, Leuven, Belgium). Models of intracranial skull base diseases are printed using a 3D printer before surgery. The models clearly demonstrate the morphologies of the intracranial skull base diseases and the spatial relationship with adjacent large vessels and bones. The printing time of each model is 12.52–15.32 h, and the cost ranges from 900 to 1500 RMB. The operative approach was planned in vitro, and patients recovered postoperatively well without severe complications or death. In a questionnaire about the application of 3D printing, experienced neurosurgeons achieved scores of 7.8–8.8 out of 10, while unexperienced neurosurgeons achieved scores of 9.2–9.8. Resection of intracranial skull base lesions is demonstrated to be well assisted by 3D printing technique, which has great potential in disclosing adjacent anatomical relationships and providing the required help to clinical doctors in preoperative planning.

Calvian Endo-pen: New Coagulation Forceps for Endoscopic Endonasal Transsphenoidal Surgery

2018 ◽  
Vol 79 (06) ◽  
pp. 524-527
Author(s):  
Steffen Rosahl ◽  
Geralf Kellner ◽  
Rüdiger Gerlach
Keyword(s):  
Skull Base ◽  
Transsphenoidal Surgery ◽  
Endoscopic Endonasal ◽  
Small Vessels ◽  
The Past ◽  
Bipolar Electrocoagulation ◽  
New Type ◽  
Endoscopic Endonasal Transsphenoidal Surgery ◽  
Skull Base Lesions ◽  
Anatomical Area

Objective Over the past few years bipolar electrocoagulation techniques in neurosurgery have been continually improving. However, limited access during endoscopic endonasal transsphenoidal surgery (EETS) for central skull base pathologies and the requirement of very precise coagulation in that dedicated anatomical area requires further refinement of bipolar coagulation instruments. We describe our experience (effectiveness of coagulation, intraoperative handling, and the use as a dissecting tool) with a new type of coagulation forceps, the Calvian endo-pen (Sutter Medizintechnik, Freiburg, Germany) during EETS. Method From June to August 2015, 12 patients with central skull base lesions (9 with a pituitary adenoma and 1 each with epidermoid, hemangioma, and juvenile angiofibroma) were operated on with the Calvian endo-pen. Results The application of the Calvian endo-pen was feasible in all cases. The angled thin tips proved to be very effective and precise for soft tissue coagulation to achieve hemostasis. Even very small vessels could be occluded selectively. It was also helpful for outward dissection in separating normal from tumor tissue. Conclusion The use of the Calvian endo-pen is safe and effective during EETS for central skull base pathologies. Its ease in intraoperative handling (maneuverability, cleaning) and precise coagulation makes it a promising instrument for EETS.

scholarly journals Endoscopic endonasal transsphenoidal surgery: implementation of an operative and perioperative checklist

2014 ◽  
Vol 37 (4) ◽  
pp. E1 ◽  
Author(s):  
Eisha Christian ◽  
Brianna Harris ◽  
Bozena Wrobel ◽  
Gabriel Zada
Keyword(s):  
Surgical Treatment ◽  
Skull Base ◽  
Transsphenoidal Surgery ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Surgical Equipment ◽  
Endoscopic Endonasal ◽  
Near Misses ◽  
Endoscopic Endonasal Transsphenoidal Surgery ◽  
Skull Base Lesions

Endoscopic endonasal surgery relies heavily on specialized operative instrumentation and optimization of endocrinological and other critical adjunctive intraoperative factors. Several studies and worldwide initiatives have previously established that intraoperative and perioperative surgical checklists can minimize the incidence of and prevent adverse events. The aim of this article was to outline some of the most common considerations in the perioperative and intraoperative preparation for endoscopic endonasal transsphenoidal surgery. The authors implemented and prospectively evaluated a customized checklist at their institution in 25 endoscopic endonasal operations for a variety of sellar and skull base pathological entities. Although no major errors were detected, near misses pertaining primarily to missing components of surgical equipment or instruments were identified in 9 cases (36%). The considerations in the checklist provided in this article can serve as a basic template for further customization by centers performing endoscopic endonasal surgery, where their application may reduce the incidence of adverse or preventable errors associated with surgical treatment of sellar and skull base lesions.

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