Dural repair with grafts using the gastrointestinal anastomosis stapler

Repair of large dural defects requires patch duraplasty with grafts. The ideal dural repair is watertight, inert, and resistant to adhesions. When a sizable defect requires multiple grafts, the grafts can be hand sewn to form one large sheet. This method can add significant time to the operative course. In addition, the risk of cerebrospinal fluid leakage is high with multiple hand-sewn seams. To reduce operating time and decrease the risk of cerebrospinal fluid leakage, we have used the 80-mm gastrointestinal anastomosis stapler with 3.8-mm titanium staples to create large sheets of graft material for dural repair. In 3 patients requiring repair of large dural defects, this method has produced seams that were atraumatic and watertight.