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Simple dural closure using a knotless barbed suture in endoscopic transsphenoidal surgery: preliminary experience
Zixiang Cong1, Handong Wang1, Chiyuan Ma1
1Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.
Acta Oto-Laryngologica
|October 24, 2019
Summary
Barbed sutures simplify dural closure in endoscopic transsphenoidal surgery, reducing procedure time and effectively preventing cerebrospinal fluid (CSF) leaks. This technique offers a reliable alternative for neurosurgical procedures.
Area of Science:
- Neurosurgery
- Surgical Techniques
- Endoscopic Procedures
Background:
- Dural suturing is effective in preventing cerebrospinal fluid (CSF) leaks after transsphenoidal surgery.
- Traditional suturing and knotting techniques are technically demanding and time-consuming in transsphenoidal approaches.
Purpose of the Study:
- To introduce and evaluate a simplified dural closure method using barbed sutures.
- To assess the efficacy and feasibility of knotless barbed suturing in endoscopic transsphenoidal surgery.
Main Methods:
- Retrospective review of 33 patients undergoing dural closure with knotless barbed sutures after endoscopic transsphenoidal surgery (August 2015 - September 2018).
- Dural suturing was performed for no/low-flow CSF leaks (grade 0-2) and as part of multilayered reconstruction for high-flow leaks (grade 3).
- Suturing time and intra/postoperative CSF leak rates were recorded.
Main Results:
- The mean dural suturing time was approximately 10 minutes.
- Intraoperative CSF leaks occurred in 16 patients (grades 1-3).
- No patients experienced postoperative cerebrospinal fluid leaks.
Conclusions:
- Dural closure with barbed sutures is a simple and reliable technique.
- This method effectively prevents postoperative cerebrospinal fluid leaks in endoscopic transsphenoidal surgery.
