Evidence map›Paper›PMID 40397185›Full record

SynthesisNeurosurgical review2025

Slicing through complexity: a systematic review assessing the efficacy and safety of water-jet dissection in neurosurgical procedures with technical suggestions.

Mohammed A Azab, Khalid Sarhan, Oday Atallah, Brahim Kammoun, Ahmed Hazim

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Mohammed A AzabDepartment of Endovascular Surgical Neurology, OBH-Brookdale University Hospital, Brooklyn, NY, USA.
Khalid SarhanFaculty of Medicine, Mansoura University, Mansoura, Egypt. kwssarhan@std.mans.edu.eg.
Oday AtallahDepartment of Neurosurgery, Carl Von Ossietzky University, Oldenburg, Germany.
Brahim KammounDepartment of Neurosurgery, Habib Bourguiba University Hospital-Sfax, Sfax, Tunisia.
Ahmed HazimDepartment of Neurosurgery, Cairo University Hospital, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Dissection methods are variable, and surgeons select the appropriate method based on its safety, efficiency and applicability. The water-jet dissection technique is a promising method that has been applied in different surgeries. We try to highlight the possible neurosurgical applications and evaluate the safety and efficacy of this technique. We conducted a comprehensive systematic review search in the following electronic databases: PubMed, Embase, Web of Science, and Cochrane Library from inception to January 2025. A qualitative synthesis was performed to summarize the findings on the efficacy, safety, and technical challenges of water-jet dissection in neurosurgery. A total of 401 patients were included in our review. Nine studies (351 patients) used the conventional water jet dissection technique, and 4 studies (50 patients) used the laser-based technique. Conventional water jet dissection has been employed in 183 cases involving glioma (52.1%), 32 cases involving meningioma (9.1%), 75 cases for other tumors (21.3%), 46 cases in epilepsy surgery (13.1%). Laser-based techniques have been less frequently used, with 10 cases reported for meningioma (12.3%), 25 cases for other tumors (30.8%), and 46 cases for vascular surgeries (56.7%). For conventional water-jet dissection, complications were observed, with vessel injury and wound infection/brain abscess occurring in 10 cases each (2.8%), post-operative edema in 3 cases (0.8%), air embolism in 1 case (0.3%), failed dissection in 13 cases (3.7%), other complications in 10 cases (2.8%), and no reported thermal injury. Only 3 (6%) complications were observed in the pulsed-based water-jet dissection technique. Water-jet dissection is a promising tool that can be used safely in neurosurgical interventions. However, precautions should be taken to minimize its potential risks and ensure optimal patient outcomes. Robust research in the form of randomized clinical trials and prospective case series should be recruited for further evaluation of this tool.

Indexed as

DissectionNeurosurgical ProceduresBrain NeoplasmsHumansTreatment OutcomeHydrodissectionPrecision dissectionTissue-selective dissectionWater-jet dissection

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.