{"id":"fb4b9024-167f-4f01-a6a4-8d61b576e689","slug":"useful-sliding-lock-knot-technique-for-suturing-dural-patch-to-prevent-cerebrospinal-fluid-leakage-after-extended-transsphenoidal-surgery","title":"Useful ‘sliding-lock-knot’ technique for suturing dural patch to prevent cerebrospinal fluid leakage after extended transsphenoidal surgery","authors":["Noriaki Sakamoto","Hiroyoshi Akutsu","Shingo Takano","Tetsuya Yamamoto","Akira Matsumura"],"abstract":"Background: Postoperative cerebrospinal fluid (CSF) leakage is a significant complication following extended transsphenoidal surgery (TSS). Various reconstruction methods have been utilized to prevent CSF leakage, including the use of grafts and flaps. The vascularized mucoseptal flap is a common choice, but multilayered closure techniques are recommended for high-flow leaks. Methods: The 'sliding-lock-knot' technique was employed for suturing a fascial patch graft to the sellar dura during extended TSS. A 6-0 nylon monofilament suture was used, and the knot was created outside the nasal cavity, allowing it to be slid into the operative field and tightened securely without loosening. Results: In a case involving a 73-year-old woman with a high-flow CSF leak after tumor resection, the dural defect was successfully closed using the 'sliding-lock-knot' technique. Postoperatively, there were no occurrences of CSF leakage or meningitis, and the patient's visual function was restored. Conclusion: The 'sliding-lock-knot' technique is a simple and effective method for dural suturing in extended TSS, helping to prevent CSF leakage. This technique is applicable in various surgical scenarios requiring suturing in confined spaces. Keywords: transsphenoidal surgery, cerebrospinal fluid, dural repair, suture technique, surgical technique, CSF leakage, fascial graft","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/fb4b9024-167f-4f01-a6a4-8d61b576e689/featured/hero-1782420965703.png","publishDate":"2013-02-20T00:00:00.000Z","doi":"10.4103/2152-7806.107546","categories":["Original Article"],"fullTextUrl":"http://sni.wpengine.com/wp-content/uploads/2015/05/3634/SNI-4-19.pdf"}