Water dissection technique of Toth for opening neurosurgical cleavage planes.
BACKGROUND
The low-pressure water dissection technique of Toth, first reported in 1987, is a method to cautiously open neurosurgical cleavage planes such as the sylvian fissure or the interhemispheric space, and the interfaces between extraparenchymal masses and the adjacent brain. The aim of this technical report is to present our long-term experience with this simple and elegant asset of microneurosurgery and to promote its widespread use.


METHODS
Water is injected under microscopic control by a hand-held syringe with a blunt needle or by an irrigating balloon applying repeated injections of physiological saline into the cleavage plane to open it.


CONCLUSIONS
The water dissection technique of Toth has been extensively used in Budapest and Helsinki in thousands of microsurgical cases, in removal of meningiomas and to open sylvian and interhemispheric fissure. In our experience, there have been no noticeable complications, and we recommend this technique for widespread use. It is a very inexpensive, simple, and effective method not requiring any expensive or complicated devices.
Nagy
Laszlo
L
Department of Neurosurgery, National Institute of Neurosurgery, MAV Hospital, Budapest, Hungary.
Ishii
Keisuke
K
Karatas
Ayse
A
Shen
Hu
H
Vajda
Janos
J
Niemelä
Mika
M
Jääskeläinen
Juha
J
Hernesniemi
Juha
J
Toth
Szabolcs
S
D004210:Dissection / Q000379:methods; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000601:surgery*; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008866:Microsurgery / Q000379:methods; D019635:Neurosurgical Procedures / Q000379:methods*; D014867:Water
D014867:Water