Novel Technical Variations and Increased Adhesive Strength in the "Birdlime" Transposition Technique for Microvascular Decompression

World Neurosurgery
Naoki OtaniKentaro Mori

Abstract

Vessel transposition is the standard procedure in microvascular decompression (MVD), which necessitates more complex and difficult surgical techniques, including suturing in the deep operative field. We recently reported the usefulness of TachoSil tissue sealing sheets soaked with fibrin glue for vessel transposition in MVD, known as the "birdlime" technique. Here we describe various technical variations and improved adhesive strength of this material for safe and optimal vessel transposition without complications. We retrospectively reviewed the operative findings of 31 consecutive patients who underwent MVD with the transposition procedure using TachoSil tissue sealing sheet soaked with fibrin glue between January 2012 and June 2017. The adhesive strength of TachoSil soaked with fibrin glue was measured using porcine dura mater. A single piece of this material was required in 13 patients, a single piece for multiple lesions was required in 5 patients, multiple pieces for a long segment were required in 12 patients, mainly with the offending vertebral artery in 9 patients, stacked pieces in 2 patients, and direct adhesion of vessels in 6 patients. All patients except 1 had total remission of symptoms immediately after the proc...Continue Reading

References

Jan 6, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Takuhiro IkedaMorihito Okada
Feb 3, 2015·The Journal of Thoracic and Cardiovascular Surgery·Norifumi TsubokawaMorihito Okada

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