Gardner Paul, Kassam Amin, Snyderman Carl, Mintz Arlan, Carrau Ricardo, Moossy John J
Department of Neurosurgery, Minimally Invasive endoNeurosurgery Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
J Neurosurg. 2008 Feb;108(2):395-400. doi: 10.3171/JNS/2008/108/2/0395.
Cerebrospinal fluid (CSF) leakage following endoscopic endonasal skull base resection can be a significant problem. A method for securing tissue grafts is needed. In this paper the authors used an endonasal suturing device to secure the graft reconstruction following endonasal tumor resection. The U-Clip anastomotic device (Medtronic), developed for cardiovascular anastomoses, was used to secure the tissue graft to native dura. A specialized needle driver and hemoclip applier were used for the application and deployment of this device. No suture tying was necessary, facilitating its endonasal application. The graft was successfully secured in its desired position to native dura by using the U-Clip anastomotic device. The patient did not suffer a postoperative CSF leak, and postoperative imaging and endoscopy revealed that the graft was in a good position. There was no complication from the use of the device. The U-Clip anastomotic device can be used as a suture device during endonasal surgery. It may prevent tissue graft migration and help prevent CSF leakage.
鼻内镜下经鼻颅底切除术后脑脊液（CSF）漏可能是一个严重问题。需要一种固定组织移植物的方法。在本文中，作者使用一种鼻内缝合装置在鼻内肿瘤切除术后固定移植物重建。为心血管吻合术开发的U形夹吻合装置（美敦力公司）用于将组织移植物固定于天然硬脑膜。使用一种专门的持针器和血管夹施用器来施用和部署该装置。无需打结缝合，便于其在鼻内的应用。通过使用U形夹吻合装置，移植物成功地固定在天然硬脑膜的理想位置。患者术后未发生脑脊液漏，术后影像学检查和内镜检查显示移植物位置良好。使用该装置未出现并发症。U形夹吻合装置可在鼻内手术中用作缝合装置。它可能防止组织移植物移位并有助于防止脑脊液漏。
