Supraorbital transciliar approach for posterior communicating aneurysm. 3D surgical video

Abstract

At the beginning of the 20th century, craniotomies for intracranial aneurysms were large due to a deficit in the illumination of the surgical field, lack of optical magnification, and inadequate surgical instruments [1,2]. Even after the microscope was introduced, the size of the craniotomies did not diminish significantly. It was only after 1981 when Sanchez-Vazquez first introduced the supraorbital transciliar approach that the craniotomies become smaller [3]. This approach allows access to the anterior skull base, the selar-para sellar region, and to the territory of the anterior circulation. Later, Perneczky1 was responsible for perfecting this surgical technique for vascular surgery. In a way, this approach offers multiples advantages like a smaller incision, no need for orbital osteotomies, fewer brain exposure, less postoperative periorbital inflammation, and excellent cosmetic results [4,5].Our work aims to present a 3D surgical video that illustrates the advantages of using a supraorbital transciliar approach for clipping a posterior communicating artery aneurysm.The patient consented to the use of the photos and surgical video for research purposes.

Keywords

• Keyhole approaches
• Microsurgery
• Transciliar approach
• Aneurysm
• Clipping