A Standard Operation Procedure of Clean and Fast Craniotomy Technique for Retrosigmoid Approach.

Clean and fast craniotomy and closure (CAC) for retrosigmoid approach with safe and satisfactory exposure remains our primary goal. A standard operation procedure (SOP) of retrosigmoid approach was developed and reviewed. Between January 2015 and January 2017, 97 patients suffering various lesions underwent surgeries using this technique in the Department of Neurosurgery, Qilu Hospital of Shandong University. The records concerning time of craniotomies, blood losses, and complications were reviewed. By applying this SOP, a craniotomy generally took 15 to 35 minutes, with an average of around 25 minutes. Six cases had a blood loss of more than 30mL during craniotomy. One patient had cerebrospinal fluid rhinorrhea and another case had subcutaneous effusion. There was no record of venous sinus injury or wound infection. To sum up, the SOP of retrosigmoid approach is simple, reliable and bloodless. In addition to avoiding complications such as venous sinus injury effectively, the SOP also benefits training of residents and early recovery after surgery (ERAS).