Cottonoids (neurosurgical patties, neurosurgical pads, or micropatties) as effective instruments for safe and successful endoscopic transsphenoidal adenomectomy.

Abstract

Neurosurgical cottonoids (also known as neurosurgical patties, pads, or micropatties) have been commonly used in microsurgical procedures to protect the surface of the brain, nerves, and vasculature and to aspirate blood, flushing solution, and cerebrospinal fluid. This article describes the unique applications of cottonoids in endoscopic transsphenoidal adenomectomy (eTSA). Several sizes of cottonoids have been used in eTSA to enhance safe surgical procedures and clear the operative field. The roles of cottonoids in eTSA are divided into three types: to serve as view-ensuring devices, to protect tissue, and to function as instruments or assist with the use of other instruments. Appropriate cottonoid use provides a well-visualized operative field, allows easy identification of bleeding areas, enables effective adenoma detachment from the cleavage layer (tumour-hypophysis interface), and permits sensitive procedures to be performed around critical structures. To achieve safe and successful neurovascular-hypophysis-protective eTSA, cottonoids play an effective role in every type of eTSA procedure, in various applications, performed under higher-resolution endoscopic vision.