ABSTRACT
Water dissection technique [WDT] represents a minimally traumatic surgical method to cautiously open neurosurgical cleavage planes such as interhemispheric space or Sylvian fissure, and the interfaces between extraaxial masses and the adjacent brain such as meningiomas, AVMs and aneurysms. This study was performed to evaluate the clinical application of this technique as an adjunct to everyday microneurosurgical procedures, such as meningioma surgery. One hundred patients with meningioma, aneurysm and arteriovenous malformations were treated surgically with the aid of water dissection in combination with conventional neurosurgical procedures. Water is injected under microscopic control by a handheld syringe with a blunt needle. The irrigation pressure is hand-controlled according to the microscopical view of the ongoing dissection. The WDT of Toth has been used in Assiut in 100 microsurgical cases, in removal of meningiomas and to open Sylvian and interhemispheric fissure. This technique does not need special equipment, and it is easily adapted to everyday microsurgical practice with no noticeable intraoperative complications