The Angelina Dissectors: A Novel Design of Dissectors for Endoscopic Endonasal Approaches

• Published in: Journal of neurological surgery. Part B, Skull base Skull base, 2020-06, Vol.81 (3), p.295-300
• Main Authors: Todeschini, Alexandre B., Otto, Bradley A., Carrau, Ricardo L., Prevedello, Daniel M.
• Format: Article
• Language: English
• Subjects: Original; Original Article
• ISSN: 2193-6331; 2193-634X
• DOI: 10.1055/s-0039-1688489

Abstract Background  The description and refinement of the transsphenoidal approach would not be possible without new tools and technologies developed by surgeons to facilitate this approach, which is nowadays the standard procedure for more than 90% of sellar lesions. The latest major change in transsphenoidal surgery was the introduction of the rigid endoscope and the subsequent description of the endoscopic endonasal approach. Traditional bayoneted instruments, when used for this technique, were inadequate. New instruments designed, specifically for this technique, are necessary to facilitate the surgeon's work and improve patient outcome. Objective  This study describes a novel design of dissectors created specifically for endoscopic endonasal approaches. Methods  To develop and design the Angelina dissectors, we used our extensive surgical experience to identify the shortcomings of the available dissectors used for transsphenoidal surgery and created the Angelina dissectors. Results  The Angelina dissector was designed with a unique shaft shape which facilitates endoscopic endonasal surgery. Conclusion  Even though an endoscopic endonasal approach is possible using other instruments, the design of these dissectors aids the surgeon's work. It is our impression, based on personal experience that it allows more freedom of movement and dexterity during the procedure, which could translate as an improved patient outcome.