New transparent peel-away sheath with neuroendoscopic orientation markers. Technical note.

The peel-away sheath in neuroendoscopic surgery offers numerous advantages and has many potential applications. However, currently available nontransparent sheaths have a critical disadvantage in that disorientation can occur, given the limited visible operative field. To overcome this obstacle, the authors have developed and clinically applied a new transparent sheath with "navigational orientation markers." The clear peel-away sheath provides a transparenchymal route, parenchymal protection, and, most importantly, direct visualization of the surroundings along the whole trajectory and at the distal edge. The navigational orientation markers add further benefits in terms of facilitating orientation in the endoscope trajectory, making this tool extremely useful in neuroendoscopic surgery.