Suction Spatula for Surgery of Vestibular Schwannomas in Supine Position: Technical Note.

BACKGROUND: Resection of vestibular schwannomas with good functional outcome remains a neurosurgical challenge. In this study, we report on our initial experience with a suction spatula, which allows free bimanual dissection of small tumors in a clear, bloodless surgical field in supine position. METHODS: Forty-one patients underwent vestibular schwannoma surgery in supine position, using a suction spatula. To analyze its feasibility, 11 aspects of the device were compared with the regular retractor. RESULTS: The suction spatula was successfully applied in all surgeries. Compared with a common spatula, the suction spatula showed superior performance during meatotomy, microsurgical and endoscopic tumor dissection, and management of bleedings. We noted no difference in ergonomics, compatibility, instrumental conflict, costs, reusability, and sterilization issues. Minor performance was related to its thickness/size. There were no significant disadvantages according to our data. There were no surgical complications related to this device. CONCLUSIONS: The main advantage of the suction spatula is in the treatment of small, mainly intrameatal vestibular schwannomas in supine patient position. It gives the surgeon a "third hand" while enabling a continuous bimanual dissection with 2 microinstruments without the use of a regular suction tip.