Waterjet Assisted Craniotome for Reduced Dural Tears

Abstract

A craniotomy is a procedure where a piece of the skull is removed in order to gain access to the brain. This is commonly done to remove brain tumors, treat epilepsy, and to treat traumatic brain injury. Currently, the craniotomy procedure involves drilling one or more burr holes and then using a craniotome to complete the cut. The craniotome consists of a rotating cutting tool and a dura guard, which is intended to prevent the cutting tool from touching the dura. However, even with the dura guard, dural tears occur in approximately 20–30% of craniotomy procedures [1], [2]. There are approximately 160,000 craniotomies performed per year in the United States [3]. Dural tears add time to the craniotomy procedure due to the increased difficulty in suturing the dura and the potential need to use synthetic dura material in order to reclose the dura. Also, if the dura tears while using the craniotome, the brain is no longer protected as the craniotomy is completed. There is a strong desire among neurosurgeons to have an improved tool for craniotomies that reduces the incidence of dural tears.