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Updated: Mar 31, 2026
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
How I do it: shoelace watertight dural closure in extended transsphenoidal surgery
Kazuhito Takeuchi1, Tetsuya Nagatani2, Toshihiko Wakabayashi3
1Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan. mail@wajit.com.
Background:
Skull base reconstruction after extended transsphenoidal surgery is essential to prevent postoperative cerebrospinal fluid leakage.
Methods:
A novel and simple technique for skull base reconstruction termed "shoelace dural closure" was devised. The dura mater was closed with a fat graft using a continuous running suture with both ends of a double-armed suture.
Conclusions:
The shoelace dural closure is an effective method for achieving watertight closure of the anterior skull base without the use of lumbar drains, fascia lata grafts, or nasoseptal flaps.
