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Wrapping method for better fat handling in endoscopic trans-sphenoidal surgery.

Fumihiro Matano1, Shigeyuki Tahara1, Yujiro Hattori1

  • 1Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan.

Surgical Neurology International
|November 11, 2024
PubMed
Summary

Surgicel®-wrapped fat improves handling during endoscopic transsphenoidal surgery (ETSS), effectively preventing cerebrospinal fluid (CSF) leakage. This method enhances surgical outcomes by making fat grafts easier to manage.

Keywords:
Endoscopic trans-sphenoidal surgeryFat handlingSurgicel wrap

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Area of Science:

  • Neurosurgery
  • Surgical Techniques
  • Biomaterials

Background:

  • Cerebrospinal fluid (CSF) leakage is a complication of endoscopic transsphenoidal surgery (ETSS).
  • Autologous fat grafts are commonly used to prevent CSF leakage but can be difficult to handle due to their soft and slippery nature.
  • Improved methods for fat graft manipulation are needed to enhance surgical safety and efficacy in ETSS.

Purpose of the Study:

  • To evaluate the efficacy of a novel method involving wrapping autologous fat grafts with Surgicel® for improved handling during ETSS.
  • To determine if this technique reduces the incidence of postoperative CSF leakage.

Main Methods:

  • Autologous fat tissue was harvested and cut into 5 mm pieces.
  • Surgicel® was cut into 2.5 cm² sections and used to encase the fat pieces.
  • The wrapped fat grafts were slightly moistened with saline solution before implantation during ETSS.

Main Results:

  • A total of 34 patients underwent ETSS between January 2023 and August 2024.
  • Patient age ranged from 18 to 86 years, with an average of 54.9 years.
  • No instances of postoperative CSF leakage were observed in any of the patients (0% incidence).

Conclusions:

  • The Surgicel® wrapping technique significantly improves the handling characteristics of fat grafts during ETSS.
  • This method appears to be highly effective in preventing CSF leakage following ETSS.
  • The technique offers a practical solution for surgeons performing ETSS requiring fat grafting.