The Patapata Articulating Dissector for Endoscopic Neurosurgery: Improving Precision and Expanding Surgical Access.

Abstract

Endoscopic neurosurgery enables minimally invasive access to deep-seated lesions. However, surgical manipulation is restricted by the limited maneuverability of straight instruments within narrow corridors. To address these limitations, we developed a clinically applicable articulating dissector that enables multidirectional distal-tip motion without requiring shaft movement. The dissector features a pistol-grip handle, a 130-mm shaft, and a distal tip capable of ± 45° articulation, with a 6-mm distance from the articulation joint to the tip to optimize stability. The device remained straight during insertion, allowing smooth advancement through narrow passages. We named the instrument the Patapata Dissector, using the Japanese mimetic word "patapata", which expresses the flapping motion of a bird's wings. Clinical feasibility and safety were evaluated in 20 consecutive cases: 10 endoscopic transsphenoidal surgeries and 10 endoscopic cylinder surgeries. The dissector allowed unimpeded insertion without interference from nasal structures, cylinder walls, or endoscopic equipment. During dissection, the articulating tip enabled precise multidirectional movement in deep operative fields, minimizing unintended force transmission and reducing collisions between instruments. In endoscopic transsphenoidal surgery, delicate separation of lesions from the pituitary stalk and lateral margins was achieved with minimal interference. In endoscopic cylinder surgery, the articulating tip facilitated horizontal and contralateral-side dissection beyond the cylinder boundaries. No device-related complications occurred. This newly developed articulating dissector expands the operable range and improves maneuverability in endoscopic neurosurgery by enabling controlled distal tip motion without the need for shaft manipulation. It represents a practical advancement in minimally invasive neurosurgical instrumentation.