The sizer-dissector for aneurysm clip selection: technical note.
OBJECTIVE
Appropriate clip selection frequently becomes a matter of trial and error because of inadequate dissection of the pathway for each clip blade. To facilitate selection of the proper clip size, a series of dissectors have been designed that mimic the exact caliber of each category of Sugita clips.


METHODS
Three lines of sizer-dissectors reflecting the wire size of the most commonly used Sugita clips were developed by attaching a single aneurysm clip blade to a rounded microdissector handle. Each sizer-dissector is scaled in millimeters and is available in straight and angled configurations. Once dissection is presumed to be complete, the device is passed through the pathway of the intended aneurysm clip blades, and the clip with the appropriate caliber and length for permanent occlusion is selected.


RESULTS
During dissection and clip ligation of 83 aneurysms, the sizer-dissector was used to select the blade length in 16 lesions and the blade caliber in 5 lesions. There were no complications associated with deployment of the device.


CONCLUSIONS
By use of the sizer-dissector before attempting clip placement, clip selection is facilitated, safety is enhanced, and clip wastage is reduced.
Giannotta
Steven L
SL
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. gianott@hsc.usc.edu
D004867:Equipment Design; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D009493:Neurosurgery / Q000295:instrumentation*; D013525:Surgical Instruments