Cottonoid Sliders: A Simple and Cost-Effective Tool for Retractorless Intracranial Surgery.

Diffusion injury Dynamic retraction Retraction injury Retractorless surgery Skull base surgery

Journal

Operative neurosurgery (Hagerstown, Md.)
ISSN: 2332-4260
Titre abrégé: Oper Neurosurg (Hagerstown)
Pays: United States
ID NLM: 101635417

Informations de publication

Date de publication:
15 Sep 2020
Historique:
received: 11 11 2019
accepted: 14 02 2020
pubmed: 2 5 2020
medline: 22 6 2021
entrez: 2 5 2020
Statut: ppublish

Résumé

Retraction injury can result in significant complications during intracranial operations. Alternative surgical techniques to minimize retraction pressure and duration of retraction can minimize the risk of retraction injury. We describe the use of a cottonoid "slider," which is a simple, cost-effective modification of a commonly used cottonoid, in multiple applications. The cottonoid sliders are constructed preoperatively by overlaying an adhesive plastic incision drape on one side of a dry cottonoid patty and trimming the edges to fit the form of the cottonoid. Intraoperatively, the sliders can slide across the parenchymal surface atraumatically and are used for gentle retraction to expose desired areas. In addition, suction may be placed on the slider to clear fluid from the operative view. The plastic side of the slider prevents adherence to the parenchymal surface. Retractorless surgical techniques have been developed to minimize risk of retractor associated injury in intracranial surgery by reducing retraction pressure and duration. Given that the cottonoid sliders glide along the parenchyma, do not stick, and are used for dynamic retraction, the main objectives to minimize retraction injury can be met while not compromising operative efficiency. Cottonoid sliders are a simple and cost-effective method of providing gentle exposure during intracranial surgery. This technique represents a valuable and cost-effective addition to the neurosurgical armamentarium.

Sections du résumé

BACKGROUND AND IMPORTANCE BACKGROUND
Retraction injury can result in significant complications during intracranial operations. Alternative surgical techniques to minimize retraction pressure and duration of retraction can minimize the risk of retraction injury. We describe the use of a cottonoid "slider," which is a simple, cost-effective modification of a commonly used cottonoid, in multiple applications.
CLINICAL PRESENTATION METHODS
The cottonoid sliders are constructed preoperatively by overlaying an adhesive plastic incision drape on one side of a dry cottonoid patty and trimming the edges to fit the form of the cottonoid. Intraoperatively, the sliders can slide across the parenchymal surface atraumatically and are used for gentle retraction to expose desired areas. In addition, suction may be placed on the slider to clear fluid from the operative view. The plastic side of the slider prevents adherence to the parenchymal surface. Retractorless surgical techniques have been developed to minimize risk of retractor associated injury in intracranial surgery by reducing retraction pressure and duration. Given that the cottonoid sliders glide along the parenchyma, do not stick, and are used for dynamic retraction, the main objectives to minimize retraction injury can be met while not compromising operative efficiency.
CONCLUSION CONCLUSIONS
Cottonoid sliders are a simple and cost-effective method of providing gentle exposure during intracranial surgery. This technique represents a valuable and cost-effective addition to the neurosurgical armamentarium.

Identifiants

pubmed: 32357243
pii: 5827791
doi: 10.1093/ons/opaa099
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

E428-E431

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 by the Congress of Neurological Surgeons.

Auteurs

Jianning Shao (J)

Section of Skull-Base Surgery, Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.

Hamid Borghei-Razavi (H)

Section of Skull-Base Surgery, Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
Minimally Invasive Cranial Base and Pituitary Surgery Program, Rosa Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.

Varun R Kshettry (VR)

Section of Skull-Base Surgery, Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
Minimally Invasive Cranial Base and Pituitary Surgery Program, Rosa Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.

Michael Lim (M)

Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Pablo F Recinos (PF)

Section of Skull-Base Surgery, Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
Minimally Invasive Cranial Base and Pituitary Surgery Program, Rosa Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.

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Classifications MeSH