A reproducible pull-through technique using a ligature passer for dural tenting

Area of Science:

• Neurosurgery
• Surgical Techniques

Background:

• Dural tenting is utilized to mitigate postoperative epidural hematoma risk, despite ongoing debate regarding its routine application.
• Conventional suture passage through bone flap drill holes can be technically challenging, demanding precise alignment and multiple attempts.

Purpose of the Study:

• To introduce and evaluate a novel pull-through technique for dural tenting using a ligature passer.
• To enhance the control and reproducibility of suture passage during dural tenting procedures.

Main Methods:

• A single-use wire ligature passer (LAPA-HER-CLOSURE) was employed to retrieve dural sutures through pre-drilled holes in the bone flap.
• The device facilitated controlled capture and withdrawal of sutures, replacing traditional blind threading methods.

Main Results:

• The technique eliminated blind suture passage, minimizing repeated attempts and unnecessary surgical manipulation.
• Stable and reproducible suture passage was achieved, simplifying bone flap handling.
• The intuitive design requires minimal specialized training, potentially reducing operative time for dural tenting.

Conclusions:

• This pull-through technique offers a simple, practical refinement for reliable dural suture passage.
• The method enhances surgical efficiency and simplifies bone flap management in procedures requiring dural tenting.