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Background <p>Watertight dural closure in deep endoscopic endonasal surgery remains technically demanding, largely due to restricted workspace and limited instrument maneuverability.</p> Method <p>We describe a standardized, stepwise dural suturing technique based on three core principles: workspace optimization, adaptive grip strategy, and controlled needle handling. Detailed strategies for instrument selection, needle trajectory, and graft-based sealing are presented to enhance reproducibility.</p> Conclusion <p>Systematic application of these principles enables reliable, watertight dural closure in deep endoscopic fields and may facilitate broader application of dural suturing as a reconstructive technique.</p>

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Technical principles of watertight dural closure in endoscopic endonasal surgery: How I do it

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月27日

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  • Hirotaka Hasegawa,
  • Yuki Kawaguchi,
  • Shunya Hanakita

摘要

Background

Watertight dural closure in deep endoscopic endonasal surgery remains technically demanding, largely due to restricted workspace and limited instrument maneuverability.

Method

We describe a standardized, stepwise dural suturing technique based on three core principles: workspace optimization, adaptive grip strategy, and controlled needle handling. Detailed strategies for instrument selection, needle trajectory, and graft-based sealing are presented to enhance reproducibility.

Conclusion

Systematic application of these principles enables reliable, watertight dural closure in deep endoscopic fields and may facilitate broader application of dural suturing as a reconstructive technique.