Fig. 5.

Endoscopic clipping suture of large-sized incidental dural tear. (A) A large-sized flap tear of about 15 mm (*) at the midline of the dura. The size of head of curette (★) is about 5 mm. (B) Endoscopic clipping suture needs a ring grasper for narrowing of the tear gap to help suture, vascular clip (3-mm sized clip). The third portal should be made at 2 cm lateral from the middle of the standard portals for viewing for an arthroscope. The other two portals are for a ring grasper and a vascular clip.