Title

Clip retraction of the tentorium: application of a novel technique for tentorial retraction during supracerebellar transtentorial approaches.

Department

Neurosurgery

Document Type

Article

Abstract

Supracerebellar transtentorial (SCTT) approaches have become a popular option for treatment of a variety of pathologies in the medial and basal temporal and occipital lobes and thalamus. Transtentorial approaches provide numerous advantages over transcortical approaches, including obviating the need to traverse eloquent cortex, not requiring parenchymal retraction, and circumventing critical vascular structures. All of these approaches require a tentorial opening, and numerous techniques for retraction of the incised tentorium have been described, including sutures, fixed retractors, and electrocautery. However, all of these techniques have considerable drawbacks and limitations. The authors describe a novel application of clip retraction of the tentorium to the supracerebellar approaches in which an aneurysm clip is used to suspend the tentorial flap, and an illustrative case is provided. Clip retraction of the tentorium is an efficient, straightforward adaptation of an established technique, typically used for subtemporal approaches, that improves visualization and surgical ergonomics with little risk to nearby venous structures. The authors find this technique particularly useful for the contralateral SCTT approaches.

Publication Date

4-24-2020

Publication Title

Journal of neurosurgery

ISSN

1933-0693

First Page

1

Last Page

5

PubMed ID

32330880

Digital Object Identifier (DOI)

10.3171/2020.2.JNS19295

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