Objectives: Self-closing nitinol U-clips (Medtronic, Inc., Minneapolis, MN) have primarily been used by vascular surgeons to facilitate vessel anastomosis. The advantage of this device is that it obviates the need for suturing when manipulation of the tissue or needle is prohibitive. The current report describes a novel use of the U-clip as an aid in endoscopic reconstruction of the skull base. Methods/Participants: Two patients underwent U-clip assisted skull base repair. The first patient underwent transnasal endoscopic repair of an ethmoidal meningoencephalocele requiring primary dural closure and the second underwent odontoidectomy for basilar invagination via an endoscopic transnasal approach requiring primary closure of the soft tissues. Study Design – Case Series Results: The defects were successfully closed using the U-Clip anastomotic device. No cerebrospinal fluid leaks were experienced postoperatively. Intraoperative evaluation combined with postoperative imaging confirmed a satisfactory reconstruction. Conclusions: The U-clip device may be used as an adjunct in select cases to facilitate endoscopic skull base reconstruction. The use of this tool may prevent tissue migration and enhance dural closure. It may be particularly useful in cases where narrow operative corridors make conventional suturing technically difficult.

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