The Use of a Bipolar Sealer System in Endoscopic Endonasal Surgery of the Skull Base: A Technical Note.

Background: Endoscopic endonasal approaches (EEA) have emerged to become an integral modality in the field of skull base surgery. As the indications for EEA evolve to encompass the resection of large, complex masses that often encase vessels and cranial nerves, the need for safe and effective hemostasis also becomes critical. Although significant strides have been made in the fields of optics and instrumentation, the last decade has seen little development in coagulation systems that can comfortably maneuver within the narrow confines of the endonasal corridor.

Objective: The authors aim to describe the novel clinical application of an irrigating bipolar sealer system in endonasal skull base surgery.

Materials and Methods: The Aquamantys bipolar sealer system (Medtronic, Inc., Portsmouth, New Hampshire, United States) assisted with hemostasis endoscopic, endonasal cases from 2010 to 2014 at the Ohio State University Medical Center. Illustrative examples of the main applications of the device are provided.

Conclusion: Initial experience with the presented device suggests that its use in endonasal skull base surgery is effective in select circumstances. Further studies are required to confirm its safety and clinical impact in larger populations.