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01-08-2021 | Incision | Original Article - Neurosurgical Anatomy

Impact of C-shaped skin incision on surgical operability in the retrosigmoid approach: when a good start is half of the job

Authors: Filippo Gagliardi, Martina Piloni, Silvia Snider, Francesca Roncelli, Edoardo Pompeo, Anthony J. Caputy, Pietro Mortini

Published in: Acta Neurochirurgica | Issue 8/2021

Abstract

Background

The retrosigmoid approach (RSA) is one of the routes of choice to approach tumors and vascular lesions of the cerebellopontine angle. Among different types of skin incisions and soft tissue dissection techniques, the most widely used variants comprise the straight/lazy S-shaped and the C-shaped incisions. Several reports discuss advantages in terms of functional and clinical outcomes of the C-shaped incision, but scientific considerations about the critical impact of this kind of incision on surgical operability are still extremely limited.

Object

Authors comparatively analyze the advantage provided by C-shaped incision in RSA in terms of anatomic exposure and surgical operability, compared with straight/lazy S-shaped one.

Methods

A comparative microanatomical laboratory investigation was conducted. The operability score (OS) was applied for quantitative analysis of surgical operability.

Results

C-shaped incision, providing a significant reduction of the overall working distance (–13%) together with an overall increase of the maneuverability area (+ 204.9%), did improve the conizing effect on the surgical corridor. It optimized overall maneuverability of surgical instruments, in terms of angle of attack (+ 27.7%), as well as maneuverability arc (+ 122%), on the entire surgical field.

C-shaped incision ensured good operability on all surgical targets (OS ranging from 2 to 3), most significantly improving surgical maneuverability at the porus trigeminus and internal acoustic meatus.

Conclusion

C-shaped incision in the RSA significantly improves anatomic exposure and surgical operability as compared with straight/lazy S-shaped incision.

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Title: Impact of C-shaped skin incision on surgical operability in the retrosigmoid approach: when a good start is half of the job
Authors: Filippo Gagliardi
Martina Piloni
Silvia Snider
Francesca Roncelli
Edoardo Pompeo
Anthony J. Caputy
Pietro Mortini
Publication date: 01-08-2021
Publisher: Springer Vienna
Keyword: Incision
Published in: Acta Neurochirurgica / Issue 8/2021
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-021-04889-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of C-shaped skin incision on surgical operability in the retrosigmoid approach: when a good start is half of the job

Abstract

Background

Object

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Object

Methods

Results

Conclusion

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