Double-faced microprobe for vessel transposition in microvascular decompression: technical note.

[BACKGROUND] Various instruments are used in microvascular decompression (MVD) to mobilize offending vessels. Most instruments have straight tips for safety but provide limited ability to retract vessels toward the surgeon. To address this limitation, we developed a double-faced microprobe, designated as the "SWAN probe," to enhance maneuverability in confined operative spaces.

[METHODS] The instrument has a 2.5-mm upward-bending tip (1.0-mm width) with multiple curved surfaces for controlled vessel manipulation. The inner face (angled at 45° with a narrow hollow) allows secure vessel capture and retraction, whereas the outer face (angled at 60° with a broader hollow) is optimized for advancing the vessel away from the nerve. Flat lateral surfaces enable gentle lateral displacement. The sandblasted surface reduces slippage and minimizes light reflection. The microprobe was used in 51 MVD procedures for trigeminal neuralgia (TN) and hemifacial spasm (HFS). Its utility and safety were assessed based on intraoperative performance across key maneuvers.

[RESULTS] Usability scores were consistently higher than the theoretical baseline representing procedures achievable with conventional straight-tip instruments. Benefits were most apparent during proximal retraction ("pull-out") maneuvers of the superior cerebellar artery. The probe also aided Teflon sling handling and controlled arachnoid incision. No procedure-related complications attributable to the instrument were observed.

[CONCLUSIONS] The double-faced microprobe allows both retraction and displacement of offending vessels, improving intraoperative maneuverability in selected situations. Within the limits of this study, the SWAN probe appears to be a safe and useful adjunct for MVD and may have broader applicability in microsurgery.