Commentary

The low-pressure water jet is used with considerable success by the authors for the opening of cerebral fissures and dissection of arachnoid and pial planes. The use of the technique in freeing meningiomas and aneurisms is well presented. The dissection pressure is quite low, coming from a fine blunt needle and connected to a handheld syringe in the surgeon's hand, giving the surgeon complete control of the pressure. Although the procedure was reported in the United States with an article by Pick in J Neurosurg in 1998, it never reached a significant level of usage.