Endoscopic-assisted strip craniectomy using a diamond drill bit attached to a dural retractor: a technical paper

Area of Science:

• Pediatric Neurosurgery
• Craniofacial Surgery
• Minimally Invasive Surgery

Background:

• Minimally invasive techniques are preferred for single-suture craniosynostosis.
• Open cranial vault remodeling is largely replaced by endoscopic strip craniectomy.
• Reducing blood loss during these procedures is critical.

Purpose of the Study:

• To describe a refined method for minimizing blood loss during strip craniectomy.
• To introduce a novel technique utilizing a high-speed drill with a diamond burr and an attachable dural retractor.
• To enhance safety and efficacy in infant craniosynostosis treatment.

Main Methods:

• Endoscopy-assisted metopic strip craniectomy was performed on a 3-month-old infant with trigonocephaly.
• A high-speed drill with a diamond burr was used for bone edge cauterization.
• A novel attachable dural retractor was employed to protect the dura and limit heat dissipation.

Main Results:

• The diamond drill bit cauterized bone edges, potentially reducing bleeding.
• The dural retractor protected the dura from thermal and mechanical injury.
• The technique demonstrated feasibility in reducing bone-edge blood loss.

Conclusions:

• This technical note shows the feasibility of reducing bone-edge blood loss during endoscopic strip craniectomy.
• The combination of a diamond burr and dural retractor is a promising approach.
• Further studies are needed to confirm safety, reproducibility, and impact on perioperative blood loss.