Work

Technical principles of watertight dural closure in endoscopic endonasal surgery: How I do it

Year: 2026

Type: article

Abstract: BACKGROUND: Watertight dural closure in deep endoscopic endonasal surgery remains technically demanding, largely due to restricted workspace and limited instrument maneuverability. METHOD: We describe a standardized, stepwise dural suturing technique based on three core principles: workspace optimization, adaptive grip strategy, and controlled needle handling. Detailed strategies for instrument selection, needle trajectory, and graft-based sealing are presented to enhance reproducibility. CONCLUSION: Systematic application of these principles enables reliable, watertight dural closure in deep endoscopic fields and may facilitate broader application of dural suturing as a reconstructive technique.

Source: Acta Neurochirurgica

DOI: 10.1007/s00701-026-06890-8

Authors: Hirotaka Hasegawa, Yuki Kawaguchi, Shunya Hanakita

Institution: Saitama Medical Center, Saitama Medical University

Language: English

Topic: Head and Neck Surgical Oncology

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,990